Ven, E. van de (2012) De follow-up van NICU-kinderen met gehoorverlies na 3-5 jaar. thesis, Medicine.
Full text available on request.Abstract
Introduction: Permanent childhood hearing impairment (PCHI) is an important problem in NICU graduates with a prevalence of 1,7 % versus 0,067 % in general population. Children with PCHI are known to have an increased risk for delayed development in several scales including psychomotor and language development. Preterms and children with (very) low birth weights are vulnerable to have developmental delays. Little is known about NICU graduates with PCHI who are vulnerable because of their combination of problems. Aim: Evaluation of etiology, severity of hearing loss (HL), school type, mode of communication, development and quality of life (QoL) in NICU graduates with hearing loss at age 3 to 5 years. Methods: As part of the DECIBEL study all children born between 2003 and 2005 with PCHI identified were included at the Dutch speech and hearing centres. NICU children were selected for evaluation of results of 2 stage AABR neonatal hearing screening, medical follow-up, audiological follow-up, school type and primary mode of communication. Development and QoL were measured at age 3-5 years by using parent reports: the Child Development Inventory (CDI), MacArthur Communicative Development Inventory and Pediatric QoL Inventory 4.0. Development and QoL was compared to former results of well baby clinic (WBC) newborns with PCHI. Results: Included were 91 NICU newborns [BW 1992 g (sd 1070); GA 32,9 wks (sd 5,3)]. Of those 5,6% passed neonatal hearing screening. In 44,3% moderate HL (40-60 dB), in 23,9% severe (60-90 dB) and in 31,8% profound HL (>90 dB) was established. In 33/91 cases parental consent was obtained for adjuvant follow up data. In 30,3% HL was of hereditary origin, in 24,2% HL was caused by asphyxia, in 9,1% by CMV-infection. In 8 cases (24,2%) no cause was identified. Up to 71,4% of NICU graduates attended schools for deaf and hard of hearing, 1 (3,6%) another form of special education, while 25% visit regular education. In 82,8% a combination of spoken en signed language was used for communication. Twenty-six NICU graduates and 64 WBC newborns completed all parent reports. Though CDI scores were not statistically significantly different, the scores of social (70,1 vs 75,2), self-help (80,0 vs 86,2) and gross motor development (72,0 vs 83,4) were considered clinically significant. Language development showed significant difference for total words signed (23,3 vs 10,6; p = 0,009). All other scores in NICU graduates on subscales of MacArthur tend to be lower. Total QoL score differed not significantly (79,4 vs 85,5), inclusive physical functioning (85,7 vs 90,4) but the subscales social functioning (75,4 vs 85,3; p = 0,004) and psychosocial health summary score (75,9 vs 82,4; p = 0,018) did for NICU graduates. Conclusion: After introduction of neonatal hearing screening en early intervention on NICUs, most NICU graduates with PCHI seem to have severe or profound hearing loss, attend schools for deaf and hard of hearing, and use a combination of signed and spoken language at age 3-5 years. NICU graduates with PCHI constitute a vulnerable population because they have an increased risk for delayed language and psychomotor development compared to their ‘healthy’ peers with PCHI. Also their quality of life, especially social functioning, is negatively affected.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Begeleider: and Straaten, Mw. Dr. H.L.M. van kinderarts-neonatoloog and Locatie: Isala Klinieken te Zwolle |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 10:41 |
| Last Modified: | 25 Jun 2020 10:41 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/239 |
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