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- Title
Auditory toxicity in late preterm and term neonates with severe jaundice.
- Authors
Amin, Sanjiv B; Saluja, Satish; Saili, Arvind; Laroia, Nirupama; Orlando, Mark; Wang, Hongyue; Agarwal, Asha
- Abstract
<bold>Aim: </bold>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).<bold>Method: </bold>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.<bold>Results: </bold>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.<bold>Interpretation: </bold>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.
- Subjects
INDIA; NEONATAL jaundice; PREMATURE infant diseases; HERPES simplex treatment; PREGNANCY complications; GESTATIONAL age; TOXICITY testing; DIAGNOSIS; THERAPEUTICS; AUDITORY evoked response; BILIRUBIN; BRAIN stem; DEAFNESS; ELECTROENCEPHALOGRAPHY; HEARING disorders; LONGITUDINAL method; RESEARCH funding; DISEASE complications
- Publication
Developmental Medicine & Child Neurology, 2017, Vol 59, Issue 3, p297
- ISSN
0012-1622
- Publication type
journal article
- DOI
10.1111/dmcn.13284