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Sensorineural hearing impairment among preterm children: a Norwegian population-based study
  1. Dagny Hemmingsen1,2,
  2. Dag Moster3,
  3. Bo Lars Engdahl4,
  4. Claus Klingenberg2,5
  1. 1 Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital of North Norway, Tromso, Norway
  2. 2 Paediatric Research Group, UiT The Arctic University of Norway Faculty of Health Sciences, Tromso, Norway
  3. 3 Institute of Global Public Health and Primary Care, UiB, Bergen, Norway
  4. 4 Norwegian Institute of Public Health, Oslo, Norway
  5. 5 Department of Paediatrics, University Hospital of North Norway, Tromsø, Norway
  1. Correspondence to Dr Dagny Hemmingsen, Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital of North Norway, Tromso, N-9038, Norway; dagny.e.hemmingsen{at}uit.no

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.

Design Population-based cohort study using data from several nationwide registries.

Setting Norwegian birth cohort 1999–2014, with data on SNHI until 2019.

Participants 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.

Main outcome measures 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.

Conclusion Preterm birth is an independent risk factor for SNHI. Invasive therapies and comorbidities increase the risk, predominantly in infants born after 28 weeks gestation.

  • Audiology
  • Epidemiology
  • Neonatology

Data availability statement

Data may be obtained from a third party and are not publicly available. The study used Norwegian governmental registries and legal restrictions do not permit the authors to share these data.

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Data availability statement

Data may be obtained from a third party and are not publicly available. The study used Norwegian governmental registries and legal restrictions do not permit the authors to share these data.

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Footnotes

  • X @ClausKlingenbe1

  • Correction notice This article has been corrected since it was first published. The first author's name has been amended.

  • Contributors DEH is guarantor; conceptualised and designed the study, performed the initial analysis, had full access to all the data in the study, takes responsibility for the integrity of the data and the accuracy of the data analysis. DM had a central role in acquisition of data, extracted and linked variables from the different data sources, took part in designing the study. BLE gave substantial contributions to the design of the work, took part in analysis of data and writing of the manuscript. CK conceptualised and designed the study, supervised and coordinated data collection, gave directions in all phases of the study, had full access to all the data in the study, took responsibility for the integrity of the data and accuracy of data analysis.

  • Funding Support to this project was provided by the Northern Norway Regional Health Authority (grant number HN-1355-17), Gerda Meyer Nyquist Gulbrandson and Gerdt Meyer Nyquist's Fund and the Norwegian SIDS and Stillbirth Society. The funders had no influence on the conduction of the research or writing this manuscript.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer-reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.