Hyperbilirubinemia and Follow-up Auditory Brainstem Responses in Preterm Infants

남기성; 곽상현; 배승훈; 김성헌; 정진세; 최재영

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자료유형: 학술저널

저자정보: 남기성 곽상현 배승훈 김성헌 정진세 최재영

저널정보: 대한이비인후과학회 Clinical and Experimental Otorhinolaryngology Clinical and Experimental Otorhinolaryngology 제12권 제2호

발행연도: 2019.1

수록면: 163 - 168 (6page)

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Objectives. Neonatal hyperbilirubinemia is considered one of the most common causative factors of hearing loss. Preterm infants are more vulnerable to neuronal damage caused by hyperbilirubinemia. This study aimed to evaluate the effect of hyperbilirubinemia on hearing threshold and auditory pathway in preterm infants by serial auditory brainstem response (ABR). In addition, we evaluate the usefulness of the unconjugated bilirubin (UCB) level compared with total serum bilirubin (TSB) on bilirubin-induced hearing loss. Methods. This study was conducted on 70 preterm infants with hyperbilirubinemia who failed universal newborn hearing screening by automated ABR. The diagnostic ABR was performed within 3 months after birth. Follow-up ABR was conducted in patients with abnormal results (30 cases). TSB and UCB concentration were compared according to hearing threshold by ABR. Results. The initial and maximal measured UCB concentration for the preterm infants of diagnostic ABR ≥40 dB nHL group (n=30) were statistically higher compared with ABR ≤35 dB nHL group (n=40) (P=0.031 and P=0.003, respectively). In follow-up ABR examination, 13 of the ABR ≥40 dB nHL group showed complete recovery, but 17 had no change or worsened. There was no difference in bilirubin level between the recovery group and non-recovery group. Conclusion. UCB is a better predictor of bilirubin-induced hearing loss than TSB in preterm infants as evaluated by serial ABR. Serial ABR testing can be a useful, noninvasive methods to evaluate early reversible bilirubin-induced hearing loss in preterm infants.

참고문헌 (25)

참고문헌 신청

Ahlfors CE / 2008 / Unbound bilirubin concentration is associated with abnormal automated auditory brainstem response for jaundiced newborns / Pediatrics 121(5):976~978

Mazeiras G / 2012 / Hyperbilirubinemia and neurodevelopmental outcome of very low birthweight infants : results from the LIFT cohort / PLoS One 7(1):e30900

Shapiro SM / 2001 / Bilirubin and the auditory system / J Perinatol 1:S52~5

Ye HB / 2012 / Bilirubin induces auditory neuropathy in neonatal guinea pigs via auditory nerve fiber damage / J Neurosci Res 90(11):2201~2213

Jiang ZD / 2014 / Impaired function of the auditory brainstem in term neonates with hyperbilirubinemia / Brain Dev 36(3):212~218

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