Abstract：
BACKGROUND: We conducted a nationwide population-based case-control study to analyse potential predisposing factors for hearing loss (HL) that present during the fetal, perinatal, and postnatal periods in prematurely born children.
METHODS: This study enrolled 21,576 children born at < 37 weeks of gestation; 3,596 with HL and 17,980 with normal hearing born between 2002 and 2015, matched for sex, age at diagnosis, and enrollment time. Data were abstracted from the concatenation of three nationwide databases for overall risk factors till the diagnosis of HL.
RESULTS: Maternal HL, maternal diabetes, particularly type 1 diabetes mellitus, and at or before 32 weeks of gestation were the major obstetric risk factors for HL. Prematurely born children who were born via cesarean section and received a combination of antenatal steroids and magnesium sulfate exhibited a significantly reduced risk of developing HL. Ear malformation was a critical predictor for HL. The major postnatal risk factors included seizure and ototoxic drugs use. Premature infants diagnosed with more than 1 diagnosis of bronchopulmonary dysplasia, necrotizing enterocolitis, and intracerebral hemorrhage were at an increased risk of developing HL. Congenital CMV infection and recurrent acute otitis were also independent postnatal factors for HL in prematurely born children.
CONCLUSIONS: To reduce the incidence of childhood HL in prematurely born children, aggressive management of premature birth-related consequences and treatable causes and longitudinal audiological follow-up with early detection and adequate intervention are crucial.
METHODS: This study enrolled 21,576 children born at < 37 weeks of gestation; 3,596 with HL and 17,980 with normal hearing born between 2002 and 2015, matched for sex, age at diagnosis, and enrollment time. Data were abstracted from the concatenation of three nationwide databases for overall risk factors till the diagnosis of HL.
RESULTS: Maternal HL, maternal diabetes, particularly type 1 diabetes mellitus, and at or before 32 weeks of gestation were the major obstetric risk factors for HL. Prematurely born children who were born via cesarean section and received a combination of antenatal steroids and magnesium sulfate exhibited a significantly reduced risk of developing HL. Ear malformation was a critical predictor for HL. The major postnatal risk factors included seizure and ototoxic drugs use. Premature infants diagnosed with more than 1 diagnosis of bronchopulmonary dysplasia, necrotizing enterocolitis, and intracerebral hemorrhage were at an increased risk of developing HL. Congenital CMV infection and recurrent acute otitis were also independent postnatal factors for HL in prematurely born children.
CONCLUSIONS: To reduce the incidence of childhood HL in prematurely born children, aggressive management of premature birth-related consequences and treatable causes and longitudinal audiological follow-up with early detection and adequate intervention are crucial.
摘要：
背景：我们进行了一项全国性的基于人群的病例对照研究，以分析胎儿期间存在的听力损失（HL）的潜在诱发因素，围产期,和早产儿童的产后时期。
方法：这项研究招募了21,576名出生在妊娠37周以下的儿童；2002年至2015年间出生的3,596名HL和17,980名听力正常的儿童，性别匹配。诊断时的年龄，和注册时间。从三个全国性数据库的串联数据中提取总体危险因素，直到诊断HL。
结果：孕产妇HL，母体糖尿病,特别是1型糖尿病，妊娠32周时或之前是HL的主要产科危险因素。通过剖宫产出生并接受产前类固醇和硫酸镁联合治疗的早产儿童发生HL的风险显着降低。耳朵畸形是HL的关键预测因子。出生后的主要危险因素包括癫痫发作和耳毒性药物的使用。早产儿诊断为支气管肺发育不良，坏死性小肠结肠炎,脑出血发生HL的风险增加。先天性CMV感染和复发性急性中耳炎也是早产儿童HL的独立产后因素。
结论：为了减少早产儿童中儿童HL的发生率，对早产相关后果和可治疗原因的积极管理,以及早期发现和充分干预的纵向听力学随访至关重要.
方法：这项研究招募了21,576名出生在妊娠37周以下的儿童；2002年至2015年间出生的3,596名HL和17,980名听力正常的儿童，性别匹配。诊断时的年龄，和注册时间。从三个全国性数据库的串联数据中提取总体危险因素，直到诊断HL。
结果：孕产妇HL，母体糖尿病,特别是1型糖尿病，妊娠32周时或之前是HL的主要产科危险因素。通过剖宫产出生并接受产前类固醇和硫酸镁联合治疗的早产儿童发生HL的风险显着降低。耳朵畸形是HL的关键预测因子。出生后的主要危险因素包括癫痫发作和耳毒性药物的使用。早产儿诊断为支气管肺发育不良，坏死性小肠结肠炎,脑出血发生HL的风险增加。先天性CMV感染和复发性急性中耳炎也是早产儿童HL的独立产后因素。
结论：为了减少早产儿童中儿童HL的发生率，对早产相关后果和可治疗原因的积极管理,以及早期发现和充分干预的纵向听力学随访至关重要.
