| Unbound bilirubin predicts abnormal automated auditory brainstem response in a diverse newborn population. | |
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MedLine Citation:
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PMID: 19242487 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: The objective of this study was to determine if plasma unbound or 'free' bilirubin concentration (B(f)) measured during the first 30 days of life is associated with subsequent abnormal hearing screening testing by automated auditory brainstem response (AABR) in a diverse population of newborns. STUDY DESIGN: An observational study of newborns receiving AABR, plasma total bilirubin concentration (TBC) and B(f) measurements and without underlying conditions known to affect hearing was conducted. Logistic regression was used to determine associations between abnormal AABR and B(f) or TBC. The impacts of a variety of clinical factors on the regression model were also assessed. RESULT: A total of 191 patients with birth weights and gestations ranging from 406 to 4727 g and 24 to 42 weeks, respectively, were studied. Among them, 175 (92%) had normal (bilateral PASS) AABR and 16 had abnormal AABR (6 had unilateral REFER AABR, and 10 had bilateral REFER AABR). Mean TBC was not significantly different in babies with normal or abnormal AABR, but mean B(f) was greater in the latter group (1.76 versus 0.93 microg per 100 ml, respectively, P=0.012). B(f), but not TBC, was associated with an abnormal AABR (B(f) adjusted odds ratio 3.3, 95% CI 1.8 to 6.1). Comparing receiver-operating characteristics curves, the B(f)/TBC ratio was a better predictor of an abnormal AABR than B(f) alone. Intraventricular hemorrhage was the only confounding clinical variable. CONCLUSION: An abnormal AABR is associated with an elevated B(f) or B(f)/TBC ratio, but not the TBC alone. The prevalence of bilirubin neurotoxicity as a cause of audiological dysfunction may be underestimated if the TBC alone is used to assess the severity of newborn jaundice. |
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Authors:
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C E Ahlfors; S B Amin; A E Parker |
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Publication Detail:
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Type: Journal Article; Research Support, N.I.H., Extramural Date: 2009-02-26 |
Journal Detail:
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Title: Journal of perinatology : official journal of the California Perinatal Association Volume: 29 ISSN: 1476-5543 ISO Abbreviation: J Perinatol Publication Date: 2009 Apr |
Date Detail:
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Created Date: 2009-03-27 Completed Date: 2009-07-30 Revised Date: 2011-06-01 |
Medline Journal Info:
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Nlm Unique ID: 8501884 Medline TA: J Perinatol Country: United States |
Other Details:
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Languages: eng Pagination: 305-9 Citation Subset: IM |
Affiliation:
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Division of Neonatology, Department of Pediatrics, California Pacific Medical Center, San Francisco, CA, USA. Ligand@centurytel.net |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Audiometry, Evoked Response* Bilirubin / blood* Birth Weight Dominance, Cerebral / physiology Erythroblastosis, Fetal / physiopathology, therapy Evoked Potentials, Auditory, Brain Stem / physiology* Exchange Transfusion, Whole Blood Gestational Age Humans Hyperbilirubinemia, Neonatal / physiopathology*, therapy Infant, Extremely Low Birth Weight* Infant, Newborn Infant, Premature, Diseases / physiopathology*, therapy Phototherapy Prognosis ROC Curve Reference Values |
| Grant Support | |
ID/Acronym/Agency:
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K-23 DC 006229-03/DC/NIDCD NIH HHS; K23 DC006229-04/DC/NIDCD NIH HHS |
| Chemical | |
Reg. No./Substance:
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635-65-4/Bilirubin |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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