Search

INTRODUCTION: Hearing impairment affects 2% to 4% of NICU graduates and is associated with several risk indicators. OBJECTIVE: Our goal was to investigate the prevalence of hearing impairment in newborns hospitalized in an NICU and its association with risk indicators. METHODS: Subjects consisted of 422 post-NICU infants who fulfilled 34 weeks of gestational age and were examined between March 2005 and December 2006. The following parameters were evaluated: perinatal asphyxia, craniofacial deformities, furosemide and aminoglycoside therapy (duration of administration), meningitis, duration of mechanical ventilation, and nursing duration in an incubator. Screening was performed with the last-generation automated auditory brainstem response (AABR) equipment, ALGO 3 (Natus Medical Inc, San Carlos, CA). RESULTS: Results were considered normal when the newborn showed response to a 35-dBNA signal bilaterally. Newborns with hearing impairment were referred for early intervention. Multivariate analysis with logistic regression was used to identify the independent risk factors for hearing disturbances. The prevalence of AABR impairment was 2.84% (12 of 422 newborns); the impairment was unilateral in 7 of the infants and bilateral in 5 of them. These 12 infants were examined with conventional ABR with the following results: 6 of them showed normal responses, and in the other 6 infants the pathologic result was confirmed. Multivariate analysis revealed a statistically significant association between hearing loss and craniofacial deformities, meningitis, and duration of mechanical ventilation (P < .001, P = .001, and P = .038, respectively). CONCLUSIONS: Although the study sample was limited, the hearing-loss rate that we found was in accordance with that reported in the literature. The prevalence of hearing impairment found when using AABR is high. The only risk factors directly associated with hearing impairment proved to be craniofacial deformities, meningitis, and duration of mechanical ventilation. [ABSTRACT FROM AUTHOR]

Abstract: Background: Small for Gestational Age (SGA) neonates often appear with haemostatic alterations, principally due to hepatic dysfunction that results from chronic intrauterine hypoxia. Polycythaemia and thrombocytopenia are common findings in this neonatal population. Study design: We performed a comparison of coagulation, natural inhibitors and fibrinolysis between SGA and Appropriate for Gestational Age (AGA) infants born full term [gestational age (G.A.) >37 weeks]. Study population consisted of 188 healthy newborns, 90 of whom were SGA (62 females and 28 males), while the rest were the control group (44 females and 54 males). Blood samples were obtained within 30 minutes following birth and before the administration of vitamin K. Investigation included: PT, INR, APTT, fibrinogen, coagulation factors II, V, VII, VIII, IX, X, XI, XII, vWillebrand factor, protein C and free protein S, antithrombin (AT), APCR, tPA and PAI-1. The independent t-test was used to compare the differences between the values of haemostatic parameters. Results: Statistical analysis revealed a significant prolongation in PT, INR, elevated levels of tPA (p <0.015, 0.01 and 0.002 respectively) and a decrease in the values of XII and free protein S (p <0.045 and 0.007 respectively) in SGA full term neonates. The two groups had similar demographic characteristics (except birth weight), without significant differences in the values of other haemostatic parameters. Conclusions: Despite of statistically significant differences in PT, INR, values of tPA, XII and free protein S, levels of haemostatic factors range within laboratory references for healthy full term newborns. These findings were not accompanied with clinical manifestations of altered haemostasis. [Copyright &y& Elsevier]