Neonatal Care Academy

Hearing screening in neonates with hyperbilirubinemia

Zahraa Muhammed Ezzeldin, Eman Sharaf, Hussein Sherif Hamdy,,Yasmine Ashraf, Abdelwahab Selim International Journal of Pediatric Otorhinolaryngology Volume 142, March 2021, 110591

Hyperbilirubinemia is toxic to the auditory pathways and to the central nervous system, leaving sequelae such as hearing loss and encephalopathy. The damage to the auditory system occurs primarily within the brainstem and cranial nerve VIII, and manifests clinically as auditory neuropathy spectrum disorder.

This study aimed to establish the relationship that exists between hyperbilirubinemia at birth as a risk factor of neonatal hearing loss in children.  There are a number of risk factors for SNHL  including low gestational age and birth weight, intrauterine and postnatal infections, neonatal asphyxia, requirement for prolonged oxygen therapy and respiratory support, hyperbilirubinemia needing exchange transfusion, surgery during the neonatal period, congenital malformations, family history of hearing impairment, and exposure to ototoxic medications such as diuretics and antibiotics.

However, Diagnosis of hearing impairment in infants and neonates is not simply possible via regular clinical examinations. Techniques used primarily involve automated Auditory Brainstem Responses (AABR) and Oto-Acoustic Emissions (OAE) that provide non-invasive recordings of physiologic auditory activity and are easily performed in neonates and infants.

Study results showed that AABR was a more reliable method of detecting hearing loss in this group of infants, and the results strengthen the arguments of previous researches who suggested that AABR screening following hyperbilirubinemia treatment should be integrated into the part of the work up of the management of jaundice.

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January 26, 2021
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