Possible Effects of Kanamycin and Incubation in Newborn Children With Low Birth Weight

Abstract

In an acoustico-vestibular follow-up investigation of 91 four- to six-year-old children with birth weight below 2000 g, the same incidence of sensorineural hearing loss (19%) was found in 54 children treated with kanamycin in the neonatal period as in a group of 37 infants not treated with kanamycin. When comparing a group of children treated with both kanamycin and incubator (54 children) with a group treated with incubator only (16 children), no definite signs of synergism between incubator noise and kanamycin were found. However, the 5 cases of moderate or severe hearing loss all belonged to the group treated with both incubator and kanamycin. These 5 children had more severe neonatal complications, especially apnea, cyanotic spells and hyperbilirubinemia, which may increase the severity of the hearing loss. Among 56 incubator treated children with normal hearing (ISO standards) 52% had an audiogram pattern suggesting minor noise-provoked cochlear lesions. Among 18 non-incubator treated children with normal hearing only one child (6%) had a similar pattern. It should be stressed, however, that these children had no clinical symptoms of hearing loss.

Noise: A Hazard for the Fetus and Newborn

“…45,46 Three such studies (since the 1974 statement by the American Academy of Pediatrics' Committee on Environmental Health 5 ) that investigated the synergism of aminoglycosides and noise exposure had conflicting results. [47][48][49] In one, all five cases of moderate-to-severe sensorineural hearing loss were in infants treated with kanamycin and kept in incubators, suggesting a synergistic response. 47 In addition, 52% of 56 incubator-treated children with normal 46 assessed hearing at 6.5 years of age in 98 preterm NICU graduates.…”

“…[47][48][49] In one, all five cases of moderate-to-severe sensorineural hearing loss were in infants treated with kanamycin and kept in incubators, suggesting a synergistic response. 47 In addition, 52% of 56 incubator-treated children with normal 46 assessed hearing at 6.5 years of age in 98 preterm NICU graduates. Nine had sensorineural hearing loss that was significantly associated with apneic spells, hyperbilirubinemia, and hypothermia and not associated with duration of incubator care or exposure to aminoglycosides or conventional ventilation.…”

In vitro Comparison of Noise Levels Produced by Different CPAP Generators

“…However, there are no studies looking directly at the effects of NICU noise on hearing loss in VLBWI. The only existing studies investigated the possible synergistic effects of incubator noise and aminoglycoside treatment on hearing impairment in preterm infants [13,14] . Nevertheless, avoidance of unnecessary noise has become one of the main goals of modern neonatal intensive care.…”

Noise as a Public Health Problem: Proceedings of the International Congress (4th) Held at Turin (Italy) on June 21-25, 1983. Volume 2.

“…Although hearing losses can always be fdund, they appear to be no greater nor more numerous than controls in, for example, musicians (Petrovic et al, 1979;Axelsson and Lindgren, 1981), mine locksmiths (Janisch, 1978), modern college students (Carter et al, 1978), children who live near airports (Fisch, 1981), incubator babies (Stennert et al, 1978;Winkel et al, 1978;Stewart and Abramovich, 1979), hearing aid users (Markides and Aryee, 1978), or even ambulance personnel (Johnson et al, 1980) and fire fighters (Reischl et al, 1981) who are exposed for short periods to siren noise at up to 115 dB SPL and whose daily 8-hr equivalent levels (L g8 8 h ) may near 100 dBA.…”