Hearing and Neurodevelopmental Outcome in Survivors of Persistent Pulmonary Hypertension of the Newborn

PEDIATRICS ◽  
1992 ◽  
Vol 90 (3) ◽  
pp. 392-396 ◽  
Author(s):  
Mary-Joan Marron ◽  
Maria A. Crisafi ◽  
John M. Driscoll ◽  
Jen-Tien Wung ◽  
Yvonne T. Driscoll ◽  
...  
Keyword(s):  
Pulmonary Hypertension ◽  
Hearing Loss ◽  
Sensorineural Hearing Loss ◽  
Neurodevelopmental Outcome ◽  
Supplemental Oxygen ◽  
Sensorineural Hearing ◽  
Persistent Pulmonary Hypertension ◽  
Arterial Oxygen ◽  
Abnormal Chest ◽  
Audiologic Testing

Thirty-four infants who had a diagnosis of severe persistent pulmonary hypertension of the newborn at birth (alveolar-arterial oxygen difference > 600) were treated without paralysis or hyperventilation to induce alkalosis. All survived. Twenty-seven of these 34 eligible infants (79%) underwent neurologic, intelligence, and audiologic testing between 10 months and 6 years of age. Children who were younger than 1 year of age at the initial hearing test were retested after they reached 2 years of age. The average IQ was within the normal range (mean = 96.23). None had sensorineural hearing loss. Severe neurologic abnormalities were seen in 4 children, 3 of whom had been severely asphyxiated at birth (determined by biochemical criteria). Mild neurologic abnormalities were observed in 5 children. Two infants had bronchopulmonary dysplasia because they required supplemental oxygen for 29 and 66 days, respectively, and had abnormal chest roentgenograms; 1 patient takes intermittent doses of albuterol (Ventolin) and neither currently requires supplemental oxygen. This study of 27 infants with severe persistent pulmonary hypertension of the newborn suggests that conservative management without induced alkalosis or respiratory paralysis is accompanied by no sensorineural hearing loss and a good neurologic outcome.

Profile and Stability of Sensorineural Hearing Loss in Persistent Pulmonary Hypertension of the Newborn

1991 ◽  
Vol 34 (6) ◽  
pp. 1362-1370 ◽  
Author(s):  
Joseph P. Walton ◽  
Karen Hendricks-Munoz
Keyword(s):  
Mechanical Ventilation ◽  
Pulmonary Hypertension ◽  
Hearing Loss ◽  
Intensive Care ◽  
Sensorineural Hearing Loss ◽  
Normal Hearing ◽  
Sensorineural Hearing ◽  
Persistent Pulmonary Hypertension ◽  
Intensive Care Nursery ◽  
Underlying Mechanisms

The purpose of this study was to examine the incidence, profile, and stability of sensorineural hearing loss (SNHL) in infants diagnosed with persistent pulmonary hypertension of the newborn (PPHN). Over a five-year period, 19 of 51 infants (37%) with PPHN were diagnosed with SNHL: 16 with bilateral and 3 with unilateral impairment. This incidence of SNHL is approximately 25 times greater than observed in graduates of our intensive care nursery. The profile of SNHL in the group of 19 children was typically downward sloping. However, there was considerable variation with respect to degree of loss. In addition, progressive SNHL was identified in 5 children whose hearing worsened an average of 55 dB at 2 to 4 kHz. On retrospective analysis, the perinatal variables associated with PPHN were comparable between hearing-impaired and normal-hearing infants. In contrast, the two groups were significantly different when treatment variables, such as the duration of mechanical ventilation or amikacin, were compared. Children with SNHL were treated for longer durations as compared to normal-hearing infants. Children with SNHL were subdivided into two groups, mild and severe, based on degree of loss and treatment variables, and compared again to the normal-hearing group. Two findings emerged from this analysis. First, the duration of hyperventilation was now the only variable significantly different between children with mild SNHL and children with normal hearing. Second, comparison of the mild with the severe SNHL groups showed that the duration of hyperventilation was similar. The pathophysiology and underlying mechanisms resulting in SNHL in PPHN survivors are discussed.

Neonatal Hyperbilirubinemia and Long-Term Outcome: Another Look at the Collaborative Perinatal Project

PEDIATRICS ◽  
1993 ◽  
Vol 92 (5) ◽  
pp. 651-657 ◽  
Author(s):  
Thomas B. Newman ◽  
Mark A. Klebanoff
Keyword(s):  
Hearing Loss ◽  
Sensorineural Hearing Loss ◽  
Neurodevelopmental Outcome ◽  
Clinical Importance ◽  
Sensorineural Hearing ◽  
Neurologic Examination ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Medical Centers ◽  
Motor Abnormalities

Objective. To examine the association between neonatal bilirubin levels and subsequent neurodevelopmental outcome. Design. Prospective cohort study. Setting. 12 US medical centers from 1959 (first births) to 1974 (last follow-up). Participants. 41 324 singleton white or black infants with birth weight ≥2500 g who had neonatal bilirubin measurements recorded and survived at least 1 year. Main outcome measures. Wechsler Intelligence Scale for Children Intelligence Quotient (IQ) at age 7 years, blinded neurologic examination at age 7 years, and sensorineural hearing loss at age 8 years. Results. There was no association between IQ and bilirubin. For example, comparing children who had maximum bilirubin levels ≥342 µmol/L (20 mg/dL) with those who had lower bilirubin levels, adjusted mean IQs were 105.0 and 103.4 in whites (difference + 1.6; 95% confidence interval [CI]: –0.4 to + 3.5) and 91.0 and 93.3 in blacks (difference –2.3; 95% CI: –4.8 to +0.2). Abnormal neurologic examination results were reported in 12 of 268 children (4.5%) with bilirubin ≥342 µmol/L (20 mg/dL) compared with 1249 of 33 004 children (3.8%) with lower levels (relative risk [RR] = 1.2; 95% CI: 0.7 to 2.1). The frequency of abnormal or suspicious neurologic examination results increased in a stepwise fashion with increasing bilirubin level (P < .001), from 4346/29 258 (14.9%) of those with bilirubin levels <171 µmol/L (10 mg/dL) to 60/268 (22.4%) of those with bilirubin levels ≥342 µmol/L (20 mg/dL), apparently due to increasing minor motor abnormalities at higher bilirubin levels. Sensorineural hearing loss was not associated with high bilirubin levels (RR = 1.0; 95% CI: 0.3 to 3.0). Conclusions. Neonatal bilirubin levels seem to have little effect on IQ, definite neurologic abnormalities, or hearing loss. Higher bilirubin levels are associated with minor motor abnormalities, but the clinical importance of this finding is limited by the weakness of the association, the mild nature of the abnormalities, and the lack of evidence that they are prevented by treatment.

In Reply: Late-Onset Hearing Loss

PEDIATRICS ◽  
1989 ◽  
Vol 83 (5) ◽  
pp. 808-808
Author(s):  
KAREN D. HENDRICKS-MUNOZ ◽  
JOSEPH P. WALTON
Keyword(s):  
Hearing Loss ◽  
High Risk ◽  
Sensorineural Hearing Loss ◽  
Late Onset ◽  
Sensorineural Hearing ◽  
Fetal Circulation ◽  
Persistent Fetal Circulation ◽  
Audiologic Testing

We concur with Nield et al who point out that progressive sensorineural hearing loss is not limited to infants with persistent fetal circulation. It was not the intent of the study to imply that delayed hearing loss was limited to infants with persistent fetal circulation. Our center routinely refers for serial audiologic testing all infants who meet the high-risk registry criteria for deafness (ASHA 1984;26:17-21). Unfortunately, many of the infants in the study did not meet criteria established by the registry and, therefore, were not referred for evaluation.

scholarly journals Risk Factors for Hearing Loss in Children following Bacterial Meningitis in a Tertiary Referral Hospital

2013 ◽  
Vol 2013 ◽  
pp. 1-9 ◽  
Author(s):  
Benson Wahome Karanja ◽  
Herbert Ouma Oburra ◽  
Peter Masinde ◽  
Dalton Wamalwa
Keyword(s):  
Risk Factors ◽  
Hearing Loss ◽  
Bacterial Meningitis ◽  
Sensorineural Hearing Loss ◽  
Healthcare Providers ◽  
Sensorineural Hearing ◽  
Tertiary Referral Hospital ◽  
Hearing Function ◽  
Children With Hearing Loss ◽  
Audiologic Testing

Objective. This study aimed to examine hearing function in children admitted with bacterial meningitis to determine the risk factors for sensorineural hearing loss.Setting. The study was conducted in the audiology unit and paediatric wards of Kenyatta National Hospital.Subjects and Methods. The study involved 83 children between the ages of six months and twelve years admitted with bacterial meningitis. The median age for the children examined was 14. On discharge they underwent hearing testing to evaluate for presence and degree of hearing loss.Results. Thirty six of the 83 children (44.4%) were found to have at least a unilateral mild sensorineural hearing loss during initial audiologic testing. Of the children with hearing loss, 22 (26.5%) had mild or moderate sensorineural hearing loss and 14 (16.9%) had severe or profound sensorineural hearing loss. Significant determinants identified for hearing loss included coma score below eight, seizures, cranial nerve neuropathy, positive CSF culture, and fever above 38.7 degrees Celsius.Conclusions. Sensorineural hearing loss was found to be highly prevalent in children treated for bacterial meningitis. There is need to educate healthcare providers on aggressive management of coma, fever, and seizures due to their poor prognostic value on hearing.

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