Chronic Auditory Toxicity in Late Preterm and Term Infants With Significant Hyperbilirubinemia
Significant hyperbilirubinemia (SHB) may cause chronic auditory toxicity (auditory neuropathy spectrum disorder and/or sensorineural hearing loss); however, total serum bilirubin (TSB) does not discriminate neonates at risk for auditory toxicity. Our objective was to compare TSB, bilirubin albumin m...
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creator | Amin, Sanjiv B Saluja, Satish Saili, Arvind Orlando, Mark Wang, Hongyue Laroia, Nirupama Agarwal, Asha |
description | Significant hyperbilirubinemia (SHB) may cause chronic auditory toxicity (auditory neuropathy spectrum disorder and/or sensorineural hearing loss); however, total serum bilirubin (TSB) does not discriminate neonates at risk for auditory toxicity. Our objective was to compare TSB, bilirubin albumin molar ratio (BAMR), and unbound bilirubin (UB) for their association with chronic auditory toxicity in neonates with SHB (TSB ≥20 mg/dL or TSB that met criteria for exchange transfusion).
Infants ≥34 weeks' gestational age (GA) with SHB during the first 2 postnatal weeks were eligible for a prospective longitudinal study in India. Comprehensive auditory evaluations were performed at 2 to 3 months of age by using auditory brainstem response, tympanometry, and an otoacoustic emission test and at 9 to 12 months of age by using audiometry. The evaluations were performed by an audiologist unaware of the degree of jaundice.
A total of 93 out of 100 infants (mean GA of 37.4 weeks; 55 boys, 38 girls) who were enrolled with SHB were evaluated for auditory toxicity. Of those, 12 infants (13%) had auditory toxicity. On regression analysis controlling for covariates, peak UB (but not peak TSB or peak BAMR), was associated with auditory toxicity (odds ratio 2.41; 95% confidence interval: 1.43-4.07;
.001). There was significant difference in the area under the receiver operating characteristic curves between UB (0.866), TSB (0.775), and BAMR (0.724) for auditory toxicity (
= .03) after controlling for covariates.
Unconjugated hyperbilirubinemia indexed by UB (but not TSB or BAMR) is associated with chronic auditory toxicity in infants ≥34 weeks' GA with SHB. |
doi_str_mv | 10.1542/peds.2016-4009 |
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Infants ≥34 weeks' gestational age (GA) with SHB during the first 2 postnatal weeks were eligible for a prospective longitudinal study in India. Comprehensive auditory evaluations were performed at 2 to 3 months of age by using auditory brainstem response, tympanometry, and an otoacoustic emission test and at 9 to 12 months of age by using audiometry. The evaluations were performed by an audiologist unaware of the degree of jaundice.
A total of 93 out of 100 infants (mean GA of 37.4 weeks; 55 boys, 38 girls) who were enrolled with SHB were evaluated for auditory toxicity. Of those, 12 infants (13%) had auditory toxicity. On regression analysis controlling for covariates, peak UB (but not peak TSB or peak BAMR), was associated with auditory toxicity (odds ratio 2.41; 95% confidence interval: 1.43-4.07;
.001). There was significant difference in the area under the receiver operating characteristic curves between UB (0.866), TSB (0.775), and BAMR (0.724) for auditory toxicity (
= .03) after controlling for covariates.
Unconjugated hyperbilirubinemia indexed by UB (but not TSB or BAMR) is associated with chronic auditory toxicity in infants ≥34 weeks' GA with SHB.</description><identifier>ISSN: 0031-4005</identifier><identifier>EISSN: 1098-4275</identifier><identifier>DOI: 10.1542/peds.2016-4009</identifier><identifier>PMID: 28954873</identifier><language>eng</language><publisher>United States: American Academy of Pediatrics</publisher><subject>Age ; Audiometry ; Babies ; Bilirubin ; Bilirubin - blood ; Biomarkers - blood ; Blood diseases ; Brain stem ; Chronic Disease ; Complications and side effects ; Ears & hearing ; Emission analysis ; Female ; Gestational age ; Health aspects ; Hearing loss ; Hearing Loss, Central - blood ; Hearing Loss, Central - diagnosis ; Hearing Loss, Central - epidemiology ; Hearing Loss, Central - etiology ; Hearing Loss, Sensorineural - blood ; Hearing Loss, Sensorineural - diagnosis ; Hearing Loss, Sensorineural - epidemiology ; Hearing Loss, Sensorineural - etiology ; Humans ; Hyperbilirubinemia ; Hyperbilirubinemia, Neonatal - blood ; Hyperbilirubinemia, Neonatal - complications ; Hyperbilirubinemia, Neonatal - diagnosis ; Incidence ; Infant ; Infant, Newborn ; Infant, Premature ; Infant, Premature, Diseases - blood ; Infant, Premature, Diseases - diagnosis ; Infant, Premature, Diseases - epidemiology ; Infant, Premature, Diseases - etiology ; Infants ; Infants (Premature) ; Jaundice ; Longitudinal Studies ; Male ; Neonates ; Neuropathy ; Pediatrics ; Premature infants ; Prospective Studies ; Regression analysis ; Risk Assessment ; Risk Factors ; ROC Curve ; Serum Albumin - metabolism ; Toxicity ; Transfusion</subject><ispartof>Pediatrics (Evanston), 2017-10, Vol.140 (4), p.1</ispartof><rights>Copyright © 2017 by the American Academy of Pediatrics.</rights><rights>Copyright American Academy of Pediatrics Oct 2017</rights><rights>Copyright © 2017 by the American Academy of Pediatrics 2017</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c456t-7e6948c0c8c3828288808212d750388ad2262b2e10743dd9334720466b718a653</citedby><cites>FETCH-LOGICAL-c456t-7e6948c0c8c3828288808212d750388ad2262b2e10743dd9334720466b718a653</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,780,784,885,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28954873$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Amin, Sanjiv B</creatorcontrib><creatorcontrib>Saluja, Satish</creatorcontrib><creatorcontrib>Saili, Arvind</creatorcontrib><creatorcontrib>Orlando, Mark</creatorcontrib><creatorcontrib>Wang, Hongyue</creatorcontrib><creatorcontrib>Laroia, Nirupama</creatorcontrib><creatorcontrib>Agarwal, Asha</creatorcontrib><title>Chronic Auditory Toxicity in Late Preterm and Term Infants With Significant Hyperbilirubinemia</title><title>Pediatrics (Evanston)</title><addtitle>Pediatrics</addtitle><description>Significant hyperbilirubinemia (SHB) may cause chronic auditory toxicity (auditory neuropathy spectrum disorder and/or sensorineural hearing loss); however, total serum bilirubin (TSB) does not discriminate neonates at risk for auditory toxicity. Our objective was to compare TSB, bilirubin albumin molar ratio (BAMR), and unbound bilirubin (UB) for their association with chronic auditory toxicity in neonates with SHB (TSB ≥20 mg/dL or TSB that met criteria for exchange transfusion).
Infants ≥34 weeks' gestational age (GA) with SHB during the first 2 postnatal weeks were eligible for a prospective longitudinal study in India. Comprehensive auditory evaluations were performed at 2 to 3 months of age by using auditory brainstem response, tympanometry, and an otoacoustic emission test and at 9 to 12 months of age by using audiometry. The evaluations were performed by an audiologist unaware of the degree of jaundice.
A total of 93 out of 100 infants (mean GA of 37.4 weeks; 55 boys, 38 girls) who were enrolled with SHB were evaluated for auditory toxicity. Of those, 12 infants (13%) had auditory toxicity. On regression analysis controlling for covariates, peak UB (but not peak TSB or peak BAMR), was associated with auditory toxicity (odds ratio 2.41; 95% confidence interval: 1.43-4.07;
.001). There was significant difference in the area under the receiver operating characteristic curves between UB (0.866), TSB (0.775), and BAMR (0.724) for auditory toxicity (
= .03) after controlling for covariates.
Unconjugated hyperbilirubinemia indexed by UB (but not TSB or BAMR) is associated with chronic auditory toxicity in infants ≥34 weeks' GA with SHB.</description><subject>Age</subject><subject>Audiometry</subject><subject>Babies</subject><subject>Bilirubin</subject><subject>Bilirubin - blood</subject><subject>Biomarkers - blood</subject><subject>Blood diseases</subject><subject>Brain stem</subject><subject>Chronic Disease</subject><subject>Complications and side effects</subject><subject>Ears & hearing</subject><subject>Emission analysis</subject><subject>Female</subject><subject>Gestational age</subject><subject>Health aspects</subject><subject>Hearing loss</subject><subject>Hearing Loss, Central - blood</subject><subject>Hearing Loss, Central - diagnosis</subject><subject>Hearing Loss, Central - epidemiology</subject><subject>Hearing Loss, Central - etiology</subject><subject>Hearing Loss, Sensorineural - blood</subject><subject>Hearing Loss, Sensorineural - diagnosis</subject><subject>Hearing Loss, Sensorineural - epidemiology</subject><subject>Hearing Loss, Sensorineural - etiology</subject><subject>Humans</subject><subject>Hyperbilirubinemia</subject><subject>Hyperbilirubinemia, Neonatal - blood</subject><subject>Hyperbilirubinemia, Neonatal - complications</subject><subject>Hyperbilirubinemia, Neonatal - diagnosis</subject><subject>Incidence</subject><subject>Infant</subject><subject>Infant, Newborn</subject><subject>Infant, Premature</subject><subject>Infant, Premature, Diseases - blood</subject><subject>Infant, Premature, Diseases - diagnosis</subject><subject>Infant, Premature, Diseases - epidemiology</subject><subject>Infant, Premature, Diseases - etiology</subject><subject>Infants</subject><subject>Infants (Premature)</subject><subject>Jaundice</subject><subject>Longitudinal Studies</subject><subject>Male</subject><subject>Neonates</subject><subject>Neuropathy</subject><subject>Pediatrics</subject><subject>Premature infants</subject><subject>Prospective Studies</subject><subject>Regression analysis</subject><subject>Risk Assessment</subject><subject>Risk Factors</subject><subject>ROC Curve</subject><subject>Serum Albumin - metabolism</subject><subject>Toxicity</subject><subject>Transfusion</subject><issn>0031-4005</issn><issn>1098-4275</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdkc-LEzEUx4Mobnf16lECXrxMze_JXIRS1F0orGDFmyGTeW2zzCQ1ycj2v3eG7i4qOSS8fPJ9eXwQekPJkkrBPhyhy0tGqKoEIc0ztKCk0ZVgtXyOFoRwOtflBbrM-Y4QImTNXqILphspdM0X6Of6kGLwDq_GzpeYTngb773z5YR9wBtbAH9NUCAN2IYOb-fDTdjZUDL-4csBf_P74HfeTRV8fTpCan3v09j6AIO3r9CLne0zvH7Yr9D3z5-26-tqc_vlZr3aVE5IVaoaVCO0I047rtm0tCaaUdbVknCtbceYYi0DSmrBu67hXNSMCKXammqrJL9CH8-5x7EdoHMQSrK9OSY_2HQy0Xrz703wB7OPv41UlGvOpoD3DwEp_hohFzP47KDvbYA4ZkMbIQSXrJl7vfsPvYtjCtN4E6UU0UITNVHVmdrbHowPLoYC98XFvoc9mGn69a1ZyUlUQxmd-eWZdynmnGD39HlKzKzazKrNrNrMqqcHb_8e-Ql_dMv_ANX0ozw</recordid><startdate>201710</startdate><enddate>201710</enddate><creator>Amin, Sanjiv B</creator><creator>Saluja, Satish</creator><creator>Saili, Arvind</creator><creator>Orlando, Mark</creator><creator>Wang, Hongyue</creator><creator>Laroia, Nirupama</creator><creator>Agarwal, Asha</creator><general>American Academy of Pediatrics</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TS</scope><scope>7U9</scope><scope>H94</scope><scope>K9.</scope><scope>M7N</scope><scope>NAPCQ</scope><scope>U9A</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>201710</creationdate><title>Chronic Auditory Toxicity in Late Preterm and Term Infants With Significant Hyperbilirubinemia</title><author>Amin, Sanjiv B ; Saluja, Satish ; Saili, Arvind ; Orlando, Mark ; Wang, Hongyue ; Laroia, Nirupama ; Agarwal, Asha</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c456t-7e6948c0c8c3828288808212d750388ad2262b2e10743dd9334720466b718a653</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Age</topic><topic>Audiometry</topic><topic>Babies</topic><topic>Bilirubin</topic><topic>Bilirubin - blood</topic><topic>Biomarkers - blood</topic><topic>Blood diseases</topic><topic>Brain stem</topic><topic>Chronic Disease</topic><topic>Complications and side effects</topic><topic>Ears & hearing</topic><topic>Emission analysis</topic><topic>Female</topic><topic>Gestational age</topic><topic>Health aspects</topic><topic>Hearing loss</topic><topic>Hearing Loss, Central - blood</topic><topic>Hearing Loss, Central - diagnosis</topic><topic>Hearing Loss, Central - epidemiology</topic><topic>Hearing Loss, Central - etiology</topic><topic>Hearing Loss, Sensorineural - blood</topic><topic>Hearing Loss, Sensorineural - diagnosis</topic><topic>Hearing Loss, Sensorineural - epidemiology</topic><topic>Hearing Loss, Sensorineural - etiology</topic><topic>Humans</topic><topic>Hyperbilirubinemia</topic><topic>Hyperbilirubinemia, Neonatal - blood</topic><topic>Hyperbilirubinemia, Neonatal - complications</topic><topic>Hyperbilirubinemia, Neonatal - diagnosis</topic><topic>Incidence</topic><topic>Infant</topic><topic>Infant, Newborn</topic><topic>Infant, Premature</topic><topic>Infant, Premature, Diseases - blood</topic><topic>Infant, Premature, Diseases - diagnosis</topic><topic>Infant, Premature, Diseases - epidemiology</topic><topic>Infant, Premature, Diseases - etiology</topic><topic>Infants</topic><topic>Infants (Premature)</topic><topic>Jaundice</topic><topic>Longitudinal Studies</topic><topic>Male</topic><topic>Neonates</topic><topic>Neuropathy</topic><topic>Pediatrics</topic><topic>Premature infants</topic><topic>Prospective Studies</topic><topic>Regression analysis</topic><topic>Risk Assessment</topic><topic>Risk Factors</topic><topic>ROC Curve</topic><topic>Serum Albumin - metabolism</topic><topic>Toxicity</topic><topic>Transfusion</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Amin, Sanjiv B</creatorcontrib><creatorcontrib>Saluja, Satish</creatorcontrib><creatorcontrib>Saili, Arvind</creatorcontrib><creatorcontrib>Orlando, Mark</creatorcontrib><creatorcontrib>Wang, Hongyue</creatorcontrib><creatorcontrib>Laroia, Nirupama</creatorcontrib><creatorcontrib>Agarwal, Asha</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Physical Education Index</collection><collection>Virology and AIDS Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Pediatrics (Evanston)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Amin, Sanjiv B</au><au>Saluja, Satish</au><au>Saili, Arvind</au><au>Orlando, Mark</au><au>Wang, Hongyue</au><au>Laroia, Nirupama</au><au>Agarwal, Asha</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Chronic Auditory Toxicity in Late Preterm and Term Infants With Significant Hyperbilirubinemia</atitle><jtitle>Pediatrics (Evanston)</jtitle><addtitle>Pediatrics</addtitle><date>2017-10</date><risdate>2017</risdate><volume>140</volume><issue>4</issue><spage>1</spage><pages>1-</pages><issn>0031-4005</issn><eissn>1098-4275</eissn><abstract>Significant hyperbilirubinemia (SHB) may cause chronic auditory toxicity (auditory neuropathy spectrum disorder and/or sensorineural hearing loss); however, total serum bilirubin (TSB) does not discriminate neonates at risk for auditory toxicity. Our objective was to compare TSB, bilirubin albumin molar ratio (BAMR), and unbound bilirubin (UB) for their association with chronic auditory toxicity in neonates with SHB (TSB ≥20 mg/dL or TSB that met criteria for exchange transfusion).
Infants ≥34 weeks' gestational age (GA) with SHB during the first 2 postnatal weeks were eligible for a prospective longitudinal study in India. Comprehensive auditory evaluations were performed at 2 to 3 months of age by using auditory brainstem response, tympanometry, and an otoacoustic emission test and at 9 to 12 months of age by using audiometry. The evaluations were performed by an audiologist unaware of the degree of jaundice.
A total of 93 out of 100 infants (mean GA of 37.4 weeks; 55 boys, 38 girls) who were enrolled with SHB were evaluated for auditory toxicity. Of those, 12 infants (13%) had auditory toxicity. On regression analysis controlling for covariates, peak UB (but not peak TSB or peak BAMR), was associated with auditory toxicity (odds ratio 2.41; 95% confidence interval: 1.43-4.07;
.001). There was significant difference in the area under the receiver operating characteristic curves between UB (0.866), TSB (0.775), and BAMR (0.724) for auditory toxicity (
= .03) after controlling for covariates.
Unconjugated hyperbilirubinemia indexed by UB (but not TSB or BAMR) is associated with chronic auditory toxicity in infants ≥34 weeks' GA with SHB.</abstract><cop>United States</cop><pub>American Academy of Pediatrics</pub><pmid>28954873</pmid><doi>10.1542/peds.2016-4009</doi><oa>free_for_read</oa></addata></record> |
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subjects | Age Audiometry Babies Bilirubin Bilirubin - blood Biomarkers - blood Blood diseases Brain stem Chronic Disease Complications and side effects Ears & hearing Emission analysis Female Gestational age Health aspects Hearing loss Hearing Loss, Central - blood Hearing Loss, Central - diagnosis Hearing Loss, Central - epidemiology Hearing Loss, Central - etiology Hearing Loss, Sensorineural - blood Hearing Loss, Sensorineural - diagnosis Hearing Loss, Sensorineural - epidemiology Hearing Loss, Sensorineural - etiology Humans Hyperbilirubinemia Hyperbilirubinemia, Neonatal - blood Hyperbilirubinemia, Neonatal - complications Hyperbilirubinemia, Neonatal - diagnosis Incidence Infant Infant, Newborn Infant, Premature Infant, Premature, Diseases - blood Infant, Premature, Diseases - diagnosis Infant, Premature, Diseases - epidemiology Infant, Premature, Diseases - etiology Infants Infants (Premature) Jaundice Longitudinal Studies Male Neonates Neuropathy Pediatrics Premature infants Prospective Studies Regression analysis Risk Assessment Risk Factors ROC Curve Serum Albumin - metabolism Toxicity Transfusion |
title | Chronic Auditory Toxicity in Late Preterm and Term Infants With Significant Hyperbilirubinemia |
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