:: Volume 21, Number 3 (Bimonthly 2017) ::
Feyz 2017, 21(3): 292-297 Back to browse issues page
Evaluation of an auditory brainstem response in icteric neonates
Ahmad Talebian, Mohammad Jahangiri, Mohammad Reza Sharif, Seyyed Alireza Moraveji, Davood Kheirkhah , Monireh Ghorbani, Maryam Hojjati, Motahareh Talebian
Assistant Professor Infectious Diseases Research Center, Kashan University of Medical Sciences, Kashan, I. R. Iran. , drkheirkhah@yahoo.com
Abstract:   (244 Views)
Background: Neonatal hyperbilirubinemia is a common and preventable cause of sensory-neural hearing impairment, which can cause difficulties in the development of speech and communication. This study was conducted to detect the toxic effect of hyperbilirubinemia on the brain stem and auditory tract in neonates with icterus admitted to Shahid Beheshti Hospital in Kashan, Iran.
Materials and Methods: This cross-sectional study was conducted on 98 neonates with increased indirect bilirubin admitted to Shahid Beheshti Hospital in Kashan during 2014-2015. The patients were referred to Matini Hospital for the assessment of the auditory brainstem response (ABR); wave latency and interpeak intervals of the waves were also evaluated. According to the serum bilirubin level, the neonates were allocated into two groups; one group had a serum bilirubin level of 13-20 mg/d and another group had a bilirubin level more than 20 mg/d.  
Results: From 98 neonates, 26 (26.5%) had a bilirubin level more than 20 mg/d and 72 (73.5%) had a bilirubin level of 13-20 mg/d. Also, 46.1% of the neonates in the first group (bilirubin< 20 mg/d) and 2.8% of the neonates in the second group (bilirubin 13-20 mg/d) had abnormal ABR (P<0.0001). There was a significant difference between the mean latency time of III and V waves and the interpeak intervals of  I-III, I-V, and III-V  waves in neonates of the two groups (P<0.05).
Conclusion: An increased indirect bilirubin level (>20 mg/d) can cause an auditory processing disorder in neonates. So, performing ABR for screening and early detection of bilirubin toxicity can be recommended as a necessary audiologic intervention in all cases of severe neonatal hyperbilirubinemia.
Keywords: Neonates, Icter, Auditory brainstem response
Full-Text [PDF 205 kb]   (81 Downloads)    
Type of Study: Research | Subject: medicine, paraclinic
Received: 2017/08/6 | Accepted: 2017/08/6 | Published: 2017/08/6
References
1. Ho NK. Neonatal jaundice in Asia. Baillieres Clin Haematol 2000; 5(1): 131-42.
2. Zhang L, Liu W, Tanswell AK. The effects of bilirubin on evoked potentials and long-term potentiation in rat hippocampus in vivo. Pediatr Res 2003; 53(6): 939-44.
3. Ambalavanan N, Carlo WA. Jaundice and heperbilirubinemia in the newborn. In: Kliegman RM, Stanton BF, St.Geme JW, Schor NF. Nelson Textbook of Pediatrics. 20th ed. Philadelphia: Elsevier; 2016. P. 871-5.
4. Gowen CW. Fetal and neonatal medicine. In: Marcdante KJ, Kliegman RM. Nelson Essentials of Pediatrics. 7th ed. Philadelphia: Elsevier Saunders; 2015. P. 186-233.
5. Oğün B, Serbetçioğlu B, Duman N, Ozkan H, Kirkim G. Long-term outcome of neonatal hyperbilirubinaemia: subjective and objective audiological measures. Clin Otolaryngol Allied Sci 2003; 28(6): 507-13.
6. Haddad J, Keesecker S. Hearing loss. In: Kliegman RM, Stanton BF, St.Geme JW, Schor NF. Nelson Textbook of Pediatrics. 20th ed. Philadelphia: Elsevier; 2016. P. 3071-80.
7. Oysu C, Ulubil A, Aslan I. Incidence of cochlear involvement in hyperbilirubinemic deafness. Ann Otol Rhinol Laryngol 2002; 111(11): 1021-5.
8. Sheykholeslami K, Kaga K. Otoacoustic emissions and auditory brainstem responses after neonatal hyperbilirubinemia. Int J Pediatr Otorhinolaryngol 2000; 52(1): 65-73.
9. Almenar Latorre A, Tapia Toca MC, Fernandwz Perez C. A compined neonatal hearing screening protocol. An Esp Pediatr 2002; 57(1): 55-9.
10. Alaee E, Sirati M, Taziki MH, Fouladinejad M. Risk Factors for Sensorineural Hearing Loss Among High-Risk Infants in Golestan Province, Iran in 2010–2011. Iran Red Crescent Med J 2015; 17(12): e20419.
11. Guihoto LM, Quintal VS, da Costa MT. Brainstem auditory evoked response in normal term neonates. Arq Neuropsiquiatr 2003; 61(4): 906-8.
12. Liang Y, Xie XM. Characteristics of auditory brain stem response in neonatal hyperbilirubinemia induced by different causes. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2011; 46(3): 190-4.
13. Ye HB, Wang J, Zhang WT, Shi HB, Yin SK. Taurine attenuates bilirubin-induced neurotoxicity in the auditory system in neonatal guinea pigs. Int J Pediatr Otorhinolaryngol 2013; 77(5): 647-54.
14. Harris MC, Bernbaum JC, Polin JR, Zimmerman R, Polin RA. Developmental follow-up of breastfed term and near-term infants with marked hyperbilirubinemia. Pediatrics 2001; 107(5): 1075-80.
15. Baradaranfar MH, Atighechi S, Dadgarnia MH, Jafari R, Karimi G, Mollasadeghi A, et al. Hearing status in neonatal hyperbilirubinemia by auditory brain stem evoked response and transient evoked otoacoustic emission. Acta Med Iran 2011; 49(2): 109-12.
16. Hulzebos CV, van Dommelen P, Verkerk PH, Dijk PH, Van Straaten HL. Evaluation of treatment thresholds for unconjugated hyperbilirubinemia in preterm infants: effects on serum bilirubin and on hearing loss? PLoS One 2013; 8(5): e62858.
17. Lee CY, Chen SJ, Tang RB. Reevaluation of recent criteria for blood exchange transfusion in term infants with hyperbilirubinemia. Acta Paediatr Taiwan 2002; 43(2): 86-90.
18. Pasanisi E, Bacciu S, Fava G, Dallatomasina M, Bacciu A, Negri M, et al. Brainstem auditory evoked potentials in neonatolpgy: the method and results in a group of normal newborns. Acta Biomed Ateneo Parmense 1996; 67(5-6): 191-5.
19. Smitherman H, Stark AR, Bhutani VK. Early recognition of neonatal hyperbilirubinaemia and its emergent management. Semin Fetal Neonatal Med 2006; 11(3): 214-24.
20. Colletti JE, Kothori S, Jackson DM, Kilgore KP, Barringer K. An emergency medicine approach to neonatal hyperbilirubinaemia. Emerg Med Clin North Am 2007; 25(4): 1117-35.
21. Tomasik T. Risk factors of hearing impairment in premature infants. Przegl Lek 2008; 65(9): 375-84.
22. Nickisch A, Massinger C, Ertl-Wagner B, von Voss H. Pedaudiologic findings after severe neonatal hyperbilirubinaemia. Eur Arch Otorhinolaryngol 2009; 266(2): 207-12.



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