Bolajoko O Olusanya1. 1. College of Medicine, University of Lagos, Maternal and Child Health Unit, Department of Community Health and Primary Care, Lagos, Nigeria. boolusanya@aol.com
Abstract
OBJECTIVE: To determine the perinatal profile and developmental risks of very low birth weight (VLBW) infants (<or=1500 g) under a universal hearing screening programme in a resource-poor country. METHODS: A case-control study of VLBW survivors matched by date of birth and sex with normal birth weight (>or=2500 g) infants delivered in an inner-city maternity hospital in Lagos, Nigeria. Hearing status was determined by two-stage screening with transient evoked otoacoustic emissions (TEOAE) followed by automated auditory brainstem response (AABR). Maternal and infant factors associated with VLBW were determined using unconditional and conditional multivariable logistic regression analyses. RESULTS: All 45 VLBW singletons (mean weight 1.3 +/- 0.1 kg) during the study period were matched with 225 controls (mean weight 3.4 +/- 0.5 kg). VLBW was associated with maternal occupation, lack of antenatal care, low 5-minute Apgar score and hyperbilirubinemia based on unmatched and matched analyses. Additionally, VLBW infants were significantly associated with failed or incomplete hearing screening outcomes. Four (10.5%) of the 38 infants tested with AABR failed, but none returned for diagnostic evaluation and one child had previously passed TEOAE. CONCLUSIONS: VLBW infants in resource-poor settings are associated with the risk of sensorineural hearing loss and other perinatal outcomes that may potentially compromise their optimal development in early childhood.
OBJECTIVE: To determine the perinatal profile and developmental risks of very low birth weight (VLBW) infants (<or=1500 g) under a universal hearing screening programme in a resource-poor country. METHODS: A case-control study of VLBW survivors matched by date of birth and sex with normal birth weight (>or=2500 g) infants delivered in an inner-city maternity hospital in Lagos, Nigeria. Hearing status was determined by two-stage screening with transient evoked otoacoustic emissions (TEOAE) followed by automated auditory brainstem response (AABR). Maternal and infant factors associated with VLBW were determined using unconditional and conditional multivariable logistic regression analyses. RESULTS: All 45 VLBW singletons (mean weight 1.3 +/- 0.1 kg) during the study period were matched with 225 controls (mean weight 3.4 +/- 0.5 kg). VLBW was associated with maternal occupation, lack of antenatal care, low 5-minute Apgar score and hyperbilirubinemia based on unmatched and matched analyses. Additionally, VLBW infants were significantly associated with failed or incomplete hearing screening outcomes. Four (10.5%) of the 38 infants tested with AABR failed, but none returned for diagnostic evaluation and one child had previously passed TEOAE. CONCLUSIONS: VLBW infants in resource-poor settings are associated with the risk of sensorineural hearing loss and other perinatal outcomes that may potentially compromise their optimal development in early childhood.