Abstract：
OBJECTIVE: To investigate the risk for sensorineural hearing impairment (SNHI) in preterm infants, and to what extent the risk is attributed to perinatal morbidities and therapies.
METHODS: Population-based cohort study using data from several nationwide registries.
METHODS: Norwegian birth cohort 1999-2014, with data on SNHI until 2019.
METHODS: 60 023 live-born preterm infants, divided in moderate-late preterm (MLP) infants (32-36 weeks), very preterm (VP) infants (28-31 weeks) and extremely preterm (EP) infants (22-27 weeks), and a reference group with all 869 797 term-born infants from the study period.
METHODS: SNHI defined by selected ICD-10 codes, recorded during minimum 5-year observation period after birth.
RESULTS: The overall SNHI prevalence in the preterm cohort was 1.4% compared with 0.7% in the reference group. The adjusted risk ratios (95% CIs) for SNHI were 1.7 (1.5-1.8) in MLP infants, 3.3 (2.8-3.9) in VP infants and 7.6 (6.3-9.1) in EP infants. Among EP infants, decreasing gestational age was associated with a steep increase in the risk ratio of SNHI reaching 14.8 (7.7-28.7) if born at 22-23 weeks gestation. Among the VP and MLP infants, mechanical ventilation and antibiotic therapy had strongest association with increased risk of SNHI, but infants not receiving these therapies remained at increased risk. Among EP infants intracranial haemorrhage increased the already high risk for SNHI. We found no signs of delayed or late-onset SNHI in preterm infants.
CONCLUSIONS: Preterm birth is an independent risk factor for SNHI. Invasive therapies and comorbidities increase the risk, predominantly in infants born after 28 weeks gestation.
METHODS: Population-based cohort study using data from several nationwide registries.
METHODS: Norwegian birth cohort 1999-2014, with data on SNHI until 2019.
METHODS: 60 023 live-born preterm infants, divided in moderate-late preterm (MLP) infants (32-36 weeks), very preterm (VP) infants (28-31 weeks) and extremely preterm (EP) infants (22-27 weeks), and a reference group with all 869 797 term-born infants from the study period.
METHODS: SNHI defined by selected ICD-10 codes, recorded during minimum 5-year observation period after birth.
RESULTS: The overall SNHI prevalence in the preterm cohort was 1.4% compared with 0.7% in the reference group. The adjusted risk ratios (95% CIs) for SNHI were 1.7 (1.5-1.8) in MLP infants, 3.3 (2.8-3.9) in VP infants and 7.6 (6.3-9.1) in EP infants. Among EP infants, decreasing gestational age was associated with a steep increase in the risk ratio of SNHI reaching 14.8 (7.7-28.7) if born at 22-23 weeks gestation. Among the VP and MLP infants, mechanical ventilation and antibiotic therapy had strongest association with increased risk of SNHI, but infants not receiving these therapies remained at increased risk. Among EP infants intracranial haemorrhage increased the already high risk for SNHI. We found no signs of delayed or late-onset SNHI in preterm infants.
CONCLUSIONS: Preterm birth is an independent risk factor for SNHI. Invasive therapies and comorbidities increase the risk, predominantly in infants born after 28 weeks gestation.
摘要：
目的：探讨早产儿发生感音神经性听力损害（SNHI）的风险，以及该风险在多大程度上归因于围产期发病率和治疗。
方法：基于人群的队列研究，使用来自多个全国注册管理机构的数据。
方法：1999-2014年挪威出生队列，截至2019年的SNHI数据。
方法：60023名活产早产儿，分为中度晚期早产（MLP）婴儿（32-36周），极早产儿（VP）（28-31周）和极早产儿（EP）（22-27周），和一个参考组，研究期间所有869797名足月出生婴儿。
方法：由选定的ICD-10代码定义的SNHI，在出生后至少5年观察期记录。
结果：早产队列中SNHI的总体患病率为1.4%，而参照组为0.7%。在MLP婴儿中，SNHI的调整风险比（95％CIs）为1.7（1.5-1.8），VP婴儿为3.3（2.8-3.9），EP婴儿为7.6（6.3-9.1）。在EP婴儿中，如果出生在22-23周时,胎龄降低与SNHI的风险比急剧增加相关,达到14.8(7.7-28.7).在VP和MLP婴儿中，机械通气和抗生素治疗与SNHI风险增加的相关性最强，但未接受这些治疗的婴儿风险仍然增加.在EP婴儿中，颅内出血增加了SNHI的高风险。我们在早产儿中没有发现迟发性或迟发性SNHI的迹象。
结论：早产是SNHI的独立危险因素。侵入性治疗和合并症增加了风险，主要在妊娠28周后出生的婴儿中。
方法：基于人群的队列研究，使用来自多个全国注册管理机构的数据。
方法：1999-2014年挪威出生队列，截至2019年的SNHI数据。
方法：60023名活产早产儿，分为中度晚期早产（MLP）婴儿（32-36周），极早产儿（VP）（28-31周）和极早产儿（EP）（22-27周），和一个参考组，研究期间所有869797名足月出生婴儿。
方法：由选定的ICD-10代码定义的SNHI，在出生后至少5年观察期记录。
结果：早产队列中SNHI的总体患病率为1.4%，而参照组为0.7%。在MLP婴儿中，SNHI的调整风险比（95％CIs）为1.7（1.5-1.8），VP婴儿为3.3（2.8-3.9），EP婴儿为7.6（6.3-9.1）。在EP婴儿中，如果出生在22-23周时,胎龄降低与SNHI的风险比急剧增加相关,达到14.8(7.7-28.7).在VP和MLP婴儿中，机械通气和抗生素治疗与SNHI风险增加的相关性最强，但未接受这些治疗的婴儿风险仍然增加.在EP婴儿中，颅内出血增加了SNHI的高风险。我们在早产儿中没有发现迟发性或迟发性SNHI的迹象。
结论：早产是SNHI的独立危险因素。侵入性治疗和合并症增加了风险，主要在妊娠28周后出生的婴儿中。
