PENGARUH ASFIKSIA NEONATAL TERHADAP TERJADINYA GANGGUAN PENDENGARAN SENSORINEURAL THE EFFECT OF NEONATAL ASPHYXIA TO SENSORINEURAL HEARING IMPAIRMENT

Abstract

Background. According to WHO, the prevalence of hearing impairment in Indonesia was 4.2%, one of the causes is asphyxia. Early detection and optimal intervention in the first 6 months of age could prevent the developmental disturbances. Objective. To determine asphyxia as a risk factor for sensorineural hearing impairment considering prematurity, ototoxic drug, mechanical ventilator. Methods. A cohort study. Subject: neonates with asphyxia who were match the criteria in Dr. Kariadi hospital on December 2009 July 2010. Control: neonates without asphyxia. Consecutive sampling were chosen. The first OAE was taken at the age <1 month, the second OAE and BERA at 3 months later. Analysis: Chisquare, Mc Nemar, non-paired t-test, logistic regression. Results. Subject: 34 neonates with asphyxia, 34 neonates without asphyxia. The sensorineural hearing impairment incidence was 35,3% in asphyxia in the first of OAE (p=0.003; RR:6.0; 95%CI:1.5-24.8), decreased to 20,6% (p=0.15) in the second of OAE. The sensorineural hearing impairment incidence in severe asphyxia was 57,1% in the first of OAE (p=0.003), decreased to 28,6% in the second of OAE (p=0.16). The moderate sensorineural hearing impairment incidence in asphyxia was 11,8% in the BERA test (p=0,14). Prematurity was not significance neither in the first nor the second of OAE (p=1.00). There were significant relationship between ototoxic drug and mechanical ventilator with sensorineural hearing impairment only in the first of OAE (p=0.005; RR:4.4; 95%CI:1.3-14.3 and p=0,03; RR:3,5; 95%CI:1,5-8,2). Asphyxia, ototoxic drug, mechanical ventilator were not a risk factors in multivariate analysis. Conclusion. Asphyxia is a risk factor for sensorineural hearing impairment at the age <1 month. The highest sensorineural hearing impairment incidence is severe asphyxia. The ototoxic drug and mechanical ventilator are a risk factors for sensorineural hearing impairment at the age <1 month. Asphyxia is not an independent risk factor for sensorineural hearing impairment. Keyword: OAE, sensorineural hearing impairment, neonatal asphyxia.