Abstract
Elevated bilirubin levels in neonates are commonly seen both physiologically and in pathological conditions. There are few articles describing the effects of elevated bilirubin levels on the auditory system. The objectives of this paper was to study the prevalence of hearing impairment in neonates with hyperbilirubinemia and assess outcome/reversibility of hearing impairment in these neonates with follow-up hearing evaluation. This was a prospective single centre, case control study. Cases: neonates, total bilirubin levels >15 mg/dl. Controls: <15 mg/dl. Exclusion criteria included neonates with neonatal hypoxia, intrauterine infections, sepsis or meningitis, infants with a family history of hearing loss, low birth weight, ototoxic medications, external and middle ear pathology. Otoacoustic emission testing (OAE) was done at birth. Neonates who fail OAE were advised follow up with Brainstem Evoked Response Audiometry (BERA) after 2 months. Neonates having abnormal BERA waves were called for follow up at 6 months. Out of 57 cases, 3 had failed OAE and had normal BERA waves on follow up at 2 months. Out of 60 controls, 5 had failed OAE and follow up BERA for 3 patients were normal and 2 babies were lost to follow up. No statistical significance in hearing impairment in hyperbilirubinemia v/s normal babies was noted. Elevated bilirubin levels in the absence of any other risk factors may not show significant changes in the hearing screening. Some effect owing to the p value close to being significant in cases has been noted. The same may not contribute to permanent hearing impairment as first OAE changes may be transient and seem to revert with age.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Ezzeldin ZM, Sharaf E, Hamdy HS, Abdelwahab Selim YA (2021) Hearing screening in neonates with hyperbilirubinemia. Int J Pediatr Otorhinolaryngol 142:110591
Mandour YM, El Sayed MA, El Sayed Morgan A, Bassam R, Fadl H, Elrefae A (2020) Audiological assessment of neonatal hyperbilirubinemia. Int J Pediatr Otorhinolaryngol 135:110126
Okhravi T, Eslami ST, Ahmadi AH, Nassirian H, Najibpour R (2015) Evaluation of auditory brain stems evoked response in newborns with pathologic hyperbilirubinemia in mashhad, iran. Iran Red Crescent Med J [Internet]. [cited 2022 Nov 6];17(2). Available from: https://pubmed.ncbi.nlm.nih.gov/25793115/
Besli GE, Metin F, Aksit MA, Saltik S (2020) Long-term Effects of Indirect Hyperbilirubinemia on Auditory and Neurological Functions in Term Newborns. Medeni Med J [Internet]. [cited 2022 Nov 3];35(1):29. Available from: https://www.pmc/articles/PMC7384494/
Castillo A, Grogan TR, Wegrzyn GH, Ly KV, Walker VP, Calkins KL (2018) Umbilical cord blood bilirubins, gestational age, and maternal race predict neonatal hyperbilirubinemia. PLoS ONE 13(6):e0197888
Hille ETM, Van Straaten HLM, Verkerk PH, Van Straaten I, Verkerk P, Hille E et al Prevalence and independent risk factors for hearing loss in NICU infants. Acta Paediatr [Internet]. 2007 Aug 1 [cited 2022 Oct 24];96(8):1155–8. Available from: https://onlinelibrary.wiley.com/doi/full/https://doi.org/10.1111/j.1651-2227.2007.00398.x
Corujo-Santana C, Falcón-González JC, Borkoski-Barreiro SA, Pérez-Plasencia D (2015) Ramos-Macías Á. C. Acta Otorrinolaringologica (English Edition) 66(6):326–331
Muchowski KE (2014) Evaluation and treatment of neonatal hyperbilirubinemia. Am Fam Physician 89(11):873–878
Mandour YM, el Sayed MA, el, sayed Morgan A, Bassam R, Fadl H, elrefae A (2020) Audiological assessment of neonatal hyperbilirubinemia. Int J Pediatr Otorhinolaryngol [Internet]. Aug 1 [cited 2022 Oct 21];135. Available from: https://docs.google.com/document/d/1UsTXu8qzppkPrTzGGLgPKl9kV42M0PfOmMHSppTKl48/edit?usp=drive_web&ouid=116760336325053295817&usp=embed_facebook
Vinodh M, Ambikapathy P, Aravind MA, Ganesh J (2014) Reversibility of brainstem evoked response audiometry abnormalities at 3 months in term newborns with hyperbilirubinemia. Indian Pediatr 51(2):134–135
Funding
The authors have no financial or non-financial interests to disclose.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of Interest
The authors do not have any potential conflicts of interest regarding this paper.
Informed Consent
Informed Consent was taken as approved by the institutional ethics committee and CTRI.
Research involving human participants and/or animals
The study was conducted after approval of the Institutional Ethics Committee and Clinical Trials Registry- India (registration number CTRI/2021/08/035944). This study was performed in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.
Additional information
Publisher’s Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Electronic Supplementary Material
Below is the link to the electronic supplementary material.
Rights and permissions
Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.
About this article
Cite this article
Padinharakandy, A., Ramaswamy, B., K, D. et al. Prospective Evaluation of Hearing Status in Neonatal Hyperbilirubinemia. Indian J Otolaryngol Head Neck Surg 76, 453–457 (2024). https://doi.org/10.1007/s12070-023-04181-7
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12070-023-04181-7