Table 2 Summary of studies examining risk of hearing loss in premature infants
Study (Year) | Design | Population and Sample Size | Outcome Measure | Results |
|---|---|---|---|---|
Mjoen (1982) [19] | cohort | 60 high-risk infants 27–44 weeks GA | ABR testing in NICU and follow-up visits | • 4 infants with evidence of SNHL. • 3/4 infants exposed to ototoxic medications (furosemide and/or aminoglycoside). |
McCann (1985) [18] | randomized controlled | 17 premature infants with BPD (7 infants received furosemide and 10 infants received placebo) | Audiology screen at discharge and follow-up visits | • Normal hearing in all infants. |
Salamy (1989) [20] | cohort | GA 24–34 weeks | ABR in NICU and follow-up; behavioral audiometry from 3 months to 4 years | • Infants with SNHL received greater amounts of furosemide for longer durations, in combination with aminoglycoside or vancomycin therapy (p < 0.001 for all factors). |
Brown (1991) [21] | case-control | 35 infants with SNHL and 70 matched hearing-intact controls | BAER testing prior to discharge from NICU | • 17/35 (49%) infants with SNHL and 6/70 (9%) controls were exposed to furosemide (p < 0.0001). |
Borradori (1997) [22] | case-control | 8 children with progressive bilateral deafness born preterm (GA ≤ 34 weeks) with 16 controls matched on GA and BW and 15 controls matched on perinatal complications | ABR at NICU discharge and follow-up | • 8/8 (100%) infants with SNHL and 13/15 (87%) controls received furosemide (NS). • Mean duration (p < 0.001), total cumulative dose (p < 0.001), and maximum daily dose (p = 0.05) were higher in SNHL group. |
Ertl (2001) [23] | case-control | 22 premature infants with SNHL and 25 controls matched on GA, BW, and perinatal factors associated with hearing loss | OAE test and ABR if failed OAE | • 4/22 (18%) infants with SNHL and 1/25 (4%) controls received furosemide (p < 0.01). |
Rais-Bahrami (2004) [24] | cohort | 57 infants who received furosemide and 207 infants who did not receive furosemide | OAE, ABR, or both prior to NICU discharge | • No difference in abnormal hearing screen in furosemide and non-furosemide groups (16% vs. 16%; p = 0.95). |
Xoinis (2007) [25] | case-control | 71 infants with SNHL, 24 with auditory neuropathy,and 95 controls matched on GA, BW, and birth year | ABR and OAE | • Higher exposure to furosemide in SNHL group (51%) and AN group (96%) compared to control group (32.6%) (p < 0.05) for both comparisons. |
Coenraad (2011) [26] | case-control | 9 infants with hearing loss and 36 controls matched on GA, gender, and birth year | ABR screening prior to NICU discharge and repeat ABR and OAE at follow-up visit for failed screening. | • No differences in furosemide exposure between groups (44% vs. 25%; p = 0.56). |
Martinez-Cruz (2012) [27] | case-control | 6 children with SNHL and 87 normal-hearing controls with birth weights < 750 g | BAER screening and OAE at follow-up visits for failed initial screening | • 6/6 (100%) infants with SNHL and 45/87 (52%) control infants received furosemide (p = 0.002). • Longer average duration of furosemide in SNHL infants who received furosemide compared with controls (18 days vs. 7 days). |
Rastogi (2013) [28] | cohort | Infants with BW < 1500 g. | ABR prior to NICU discharge; Follow-up at 2 years for failed screening to determine hearing status | • No association with furosemide and hearing loss when adjusting for BW, GA, and other perinatal risk factors (OR 1.18; p = 0.3). |
Wang (2017) [29] | cohort | Included all infants with BW ≤ 1500 g. 297 infants with normal hearing and 12 infants with hearing loss | OAE before discharge and BAER at 3 months corrected age if failed initial screen | • Exposure to ototoxins (furosemide and/or gentamicin) was associated with hearing loss (OR 3.62; 95% CI 1.67–7.82). |