Auditory toxicity in late preterm and term neonates with severe jaundice.

Abstract

AIM:

Jaundice may cause auditory toxicity (auditory neuropathy and hearing loss). However, total serum bilirubin (TSB) does not discriminate neonates at risk for auditory toxicity. We compared TSB, bilirubin:albumin molar ratio (BAMR), and unbound bilirubin for their association with auditory toxicity in neonates with severe jaundice (TSB ≥342μmol/L, or that met exchange transfusion).

METHOD:

Neonates greater or equal to 34 weeks gestational age with severe jaundice during the first 2 postnatal weeks were eligible for prospective cohort study, unless they had craniofacial malformations, chromosomal disorders, toxoplasmosis, other infections, rubella, cytomegalovirus, herpes simplex infections, surgery, or family history of congenital deafness.

RESULTS:

Twenty-eight out of 100 neonates (mean gestational age 37.4wks; 59 males, 41 females) had auditory toxicity. Peak unbound bilirubin, but not peak TSB and BAMR, was associated with auditory toxicity (p<0.05) in neonates with severe (TSB <427.5μmol/L) and extreme hyperbilirubinemia (TSB ≥427.5μmol/L). Area under the receiver operating characteristic curve for unbound bilirubin (0.78) was significantly greater (p=0.03) than TSB (0.54) among neonates with severe but not extreme hyperbilirubinemia.

INTERPRETATION:

Unbound bilirubin is more strongly associated with auditory toxicity than TSB and/or BAMR in greater or equal to 34 weeks gestational age neonates with severe jaundice. Unbound bilirubin is a better predictor than TSB in neonates with severe hyperbilirubinemia.

• Authors: Sanjiv B Amin, Satish Saluja, Arvind Saili, Nirupama Laroia, Mark Orlando, Hongyue Wang, Asha Agarwal
• Journal: Developmental medicine and child neurology (Dev Med Child Neurol) Vol. 59 Issue 3 Pg. 297-303 (03 2017) ISSN: 1469-8749 [Electronic] England
• PMID: 27718221 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't, Research Support, N.I.H., Extramural)
• Copyright: © 2016 Mac Keith Press.

Chemical References

• Bilirubin

Topics

• Bilirubin (blood)
• Cohort Studies
• Electroencephalography
• Evoked Potentials, Auditory, Brain Stem
• Female
• Gestational Age
• Hearing Loss (blood, etiology)
• Hearing Loss, Central (blood, etiology)
• Humans
• India
• Infant, Newborn
• Jaundice, Neonatal (complications, metabolism)
• Male
• Risk Factors