Auditory Brainstem Response in Term and Preterm Infants with Neonatal Complications: The Importance of the Sequential Evaluation

Abstract

Introduction Literature data are not conclusive as to the influence of neonatal complications in the maturational process of the auditory system observed by auditory brainstem response (ABR) in infants at term and preterm.

Objectives Check the real influence of the neonatal complications in infants by the sequential auditory evaluation.

Methods Historical cohort study in a tertiary referral center. A total of 114 neonates met inclusion criteria: treatment at the Universal Neonatal Hearing Screening Program of the local hospital; at least one risk indicator for hearing loss; presence in both evaluations (the first one after hospital discharge from the neonatal unit and the second one at 6 months old); all latencies in ABR and transient otoacoustic emissions present in both ears.

Results The complications that most influenced the ABR findings were Apgar scores less than 6 at 5 minutes, gestational age, intensive care unit stay, peri-intraventricular hemorrhage, and mechanical ventilation.

Conclusion Sequential auditory evaluation is necessary in premature and term newborns with risk indicators for hearing loss to correctly identify injuries in the auditory pathway.

Keywords

neonatology - evoked potentials - auditory brainstem

• References

• 1 Joint Committee on Infant Hearing. Year 2000 position statement: principles and guidelines for early hearing detection and intervention programs. Am J Audiol 2000; 9 (1) 9-29
• 2 Stephens D, Hétu R. Impairment, disability and handicap in audiology: towards a consensus. Audiology 1991; 30 (4) 185-200
• 3 Roopakala MS, Dayananda G, Manjula P , et al. A comparative study of brainstem auditory evoked potentials in preterm and full-term infants. Indian J Physiol Pharmacol 2011; 55 (1) 44-52
• 4 Lin HC, Shu MT, Lee KS, Lin HY, Lin G. reducing false positives in newborn hearing screening program: how and why. Otol Neurotol 2007; 28 (6) 788-792
• 5 Benito-Orejas JI, Ramírez B, Morais D, Almaraz A, Fernández-Calvo JL. Comparison of two-step transient evoked otoacoustic emissions (TEOAE) and automated auditory brainstem response (AABR) for universal newborn hearing screening programs. Int J Pediatr Otorhinolaryngol 2008; 72 (8) 1193-1201
• 6 Granell J, Gavilanes J, Herrero J, Sánchez-Jara JL, Velasco MJ, Martín G. [Is universal newborn hearing screening more efficient with auditory evoked potentials compared to otoacoustic emissions?]. Acta Otorrinolaringol Esp 2008; 59 (4) 170-175
• 7 Pedersen L, Møller TR, Wetke R, Ovesen T. [Neonatal hearing screening. A comparison of automatic auditory brainstem audiometry and otoacoustic emissions]. Ugeskr Laeger 2008; 170 (8) 642-646
• 8 Morgan DE, Zimmerman MC, Dubno JR. Auditory brain stem evoked response characteristics in the full-term newborn infant. Ann Otol Rhinol Laryngol 1987; 96 (2 Pt 1): 142-151
• 9 Zimmerman MC, Morgan DE, Dubno JR. Auditory brain stem evoked response characteristics in developing infants. Ann Otol Rhinol Laryngol 1987; 96 (3 Pt 1): 291-299
• 10 Ponton CW, Moore JK, Eggermont JJ. Auditory brain stem response generation by parallel pathways: differential maturation of axonal conduction time and synaptic transmission. Ear Hear 1996; 17 (5) 402-410
• 11 Jiang ZD, Xiu X, Brosi DM, Shao XM, Wilkinson AR. Sub-optimal function of the auditory brainstem in term infants with transient low Apgar scores. Clin Neurophysiol 2007; 118 (5) 1088-1096
• 12 Jiang ZD, Wilkinson AR. Brainstem auditory evoked response at term in preterm infants after perinatal hypoxia-ischaemia. Acta Paediatr 2006; 95 (11) 1400-1404
• 13 Wilkinson AR, Brosi DM, Jiang ZD. Functional impairment of the brainstem in infants with bronchopulmonary dysplasia. Pediatrics 2007; 120 (2) 362-371
• 14 Jiang ZD, Yin R, Wilkinson AR. Brainstem auditory evoked responses in very low birthweight infants with chronic lung disease. Eur J Paediatr Neurol 2007; 11 (3) 153-159
• 15 Kohelet D, Arbel E, Goldberg M, Arlazoroff A. Brainstem auditory evoked response in newborns and infants. J Child Neurol 2000; 15 (1) 33-35
• 16 Sleifer P, da Costa SS, Cóser PL, Goldani MZ, Dornelles C, Weiss K. Auditory brainstem response in premature and full-term children. Int J Pediatr Otorhinolaryngol 2007; 71 (9) 1449-1456
• 17 Jiang ZD, Brosi DM, Li ZH, Chen C, Wilkinson AR. Brainstem auditory function at term in preterm babies with and without perinatal complications. Pediatr Res 2005; 58 (6) 1164-1169
• 18 American Academy of Pediatrics, Joint Committee on Infant Hearing. Year 2007 position statement: principles and guidelines for early hearing detection and intervention programs. Pediatrics 2007; 120 (4) 898-921
• 19 Lewis DR, Marone SAM, Mendes BCA, Cruz OLM, de Nóbrega M. Comitê Multiprofissional em Saúde Auditiva COMUSA. Braz J Otorhinolaryngol 2010; 76: 121-128
• 20 Turchetta R, Orlando MP, Cammeresi MG , et al. Modifications of auditory brainstem responses (ABR): observations in full-term and pre-term newborns. J Matern Fetal Neonatal Med 2012; 25 (8) 1342-1347
• 21 Chalak S, Kale A, Deshpande VK, Biswas DA. Establishment of normative data for monoaural recordings of auditory brainstem response and its application in screening patients with hearing loss: a cohort study. J Clin Diagn Res 2013; 7 (12) 2677-2679
• 22 Casali RL, Santos MFC. Auditory brainstem evoked response: response patterns of full-term and premature infants. Braz J Otorhinolaryngol 2010; 76 (6) 729-738
• 23 Baumert M, Brozek G, Paprotny M , et al. Epidemiology of peri/intraventricular haemorrhage in newborns at term. J Physiol Pharmacol 2008; 59 (Suppl. 04) 67-75
• 24 Yanowitz TD, Jordan JA, Gilmour CH , et al. Hemodynamic disturbances in premature infants born after chorioamnionitis: association with cord blood cytokine concentrations. Pediatr Res 2002; 51 (3) 310-316
• 25 De Dooy J, Colpaert C, Schuerwegh A , et al. Relationship between histologic chorioamnionitis and early inflammatory variables in blood, tracheal aspirates, and endotracheal colonization in preterm infants. Pediatr Res 2003; 54 (1) 113-119
• 26 Dammann O, Leviton A. Maternal intrauterine infection, cytokines, and brain damage in the preterm newborn. Pediatr Res 1997; 42 (1) 1-8
• 27 Hille ET, van Straaten HI, Verkerk PH ; Dutch NICU Neonatal Hearing Screening Working Group. Prevalence and independent risk factors for hearing loss in NICU infants. Acta Paediatr 2007; 96 (8) 1155-1158
• 28 Amorim RB, Agostinho-Pesse RS, Alvarenga KdeF. The maturational process of the auditory system in the first year of life characterized by brainstem auditory evoked potentials. J Appl Oral Sci 2009; 17 (Suppl): 57-62