Brainstem evoked response auditory in healthy term neonates with hyperbilirubinemia
Background Bilirubin in healthy term neonates, especially freeÂ bilirubin (Bf), could enter brain cell and cause damage perceivedÂ by brainstem evoked response auditory (BERA). Studies identifyÂ that Bf is more associated to abnonnal BERA than total bilirubinÂ is. Currently, phototherapy is perfonned in neonates with totalÂ bilirubin > 15 mg/dL. However, in developing countries whereÂ observation could not be done optimally, neonates \\lith total
bilirubin> 12 mg/dL will be subject for phototherapy.
Objectives To determine the association between total bilirubinÂ > 12 mg/dL and BERA abnonnalities in healthy tenn neonates,Â and the value of total bilirubin and free bilirubin that initiateÂ abnonnal BERA.
Methods This cross sectional study was carried out between MarchÂ 31ô€…August 8, 2008, in healthy term neonates at roomingô€…in ward,Â Department of Obstetric & Gy necology, Cipto MangunkusumoÂ Hospital (CMH). All eligible subjects were examined for Bf andÂ BERA using standard methods.Â
Results The prevalence of abnormal BERA was 15.4%. ThereÂ was no significant relation between hy perbilirubinemia (> 12 mg/Â dL) and abnonnal BERA in healthy tenn neonates. Lowest totalÂ bilirubin and Bf level related to abnonnal BERA were 12.4 mg/dLÂ (mean 12.8 mg/dL) and O.oS)Lg/dL (mean l.3)Lg/dL), respectively.Â All BERA abnonnalities were unilateral.
Conclusions There is no association between abnormal BERAÂ and hyperbilirubinemia (total bilirubin> 12 mg/dL) in jaundicedÂ infants who undergo phototherapy.
2. American Association of Pediatric . Clinical practice guidelines: Management of hyperbilirubinemia in the newborn 35 or more weeks gestation. Pediatrics. 2004; 114:297-316.
3. Volpe JJ. Bilirubin and brain injury. In: Volpe JJ, editor. Neurology of the newborn. 4th ed. Philadelphia: WB Saunders, 2001; p.521A6.
4. Porter ML, Dennis BL. H yperbilirubinemia in the term newborns. Am Fam Physic. 2002;65:599-606.
5. Reiser D. Hyperbilirubinemia: exploring neonatal condition related to bilirubin production. Awhonn lifelines. 2001;7:55-61.
6. Jaringan nasional pelatihan klinik, WHO, Indonesian Ministry of Health. Pelatihan pelayanan obstetri neonatal emergensi dasar, buku acuan. Jakarta: Indonesian Ministry of Health; 2002.
7. American Academy of Pediatric Guideline. Pediatrics.
8. Amin SB, Ahlfors C, Orlando MZ, Dahl! LE, Merle KS, Guillet R. Bilirubin and serial auditory brainstem responses in premature infants. Pediatrics. 2001; 107 :664-70.
9. Wennberg RP, Ahlfors CE, Bhutani VK, Johnson LH, Shapiro SM. Toward Understanding Kernicterus: A Challenge to Improve the Management of Jaundiced Newoorns. Pediatrics. 2006;117;474-85.
10. Ives NK. Neonatal jaundice. In: RennieJM, Roberton NRC, editors. Textbook of Neonatology. 3th ed. Edinburgh: Churcill Livingstone 1999; p.715-32.
11. Maisels MJ, Newman TB. Kernicterus occurs in otherwise healthy, breastfed term newborns. Pediatrics. 1996:730-33.
12. Sharma p, Changhani Np, MeenaKR,Jora R, Sharma, Gupta BD. Brainstem Evoked Response Audiometry (BERA) in neonates with hyperbilirubinemia. Indian J Pediatr. 2006;73;413-6
13. Jiang ZD, Chen C, Liu IT, Wolkinson AR. Changes in term neonates \\lith hyperbilirubinemia. Pediatr Neurol. 2007;37,35-41.
14. Agrawal YK, Shukla R, Misra PK, Kapoor RK, Malik GK. Brainstem auditory evoked response in newborns with hyperbilirubinemia. Indian J Pediatr. 1998;35:513-8.
15. Gupta AK, Mann SB. Is auditory brainstem response a bilirubin toxicity marker? AmJ Otolaryngol. 1998;19:232-6.
16. Funato M, Tamai H, Shimada S, Nakamura H. Vigintophobia, unbound bilirubin, and auditory brainstem responses. Pediatrics. 1994; 93,50-3.
17. Nakamura H, Takada S, Shimabuku R, Matsuo M, Tamotsu M, Negishi H. Auditory nerve and brainstem responses in newborn infants with hyperbilirubinemia. Pediatrics. 1985;75:70308.
18. Chukwuma GN, Van Aerde J, ooyden M, Perlman M. Changes in auditory brainstem responses in hyperbilirubinemic infants before and after exchange transfusion. Pediatrics. 1984;74,800-3
19. Perlman M, Fainmesser P, Sohmer H, Tamari H, Wax Y, Pevsmer B. Auditory nerveô€±brainstem evoked responses in hyperbilirubinemic neonates. Pediatrics. 1983 ;72:658-64.
20. Sleifer P, da Costa SS, Coser PL, Goldani MZ, Dornelles C, Weiss K. Auditory brainstem responses in premature and full-term children. Int J Pediatr Otorhinolaryngol. 2007: 71: 1449-56.
21. Suwento R, Hendannin H, Zizlavsky S. Gangguan pendengaran pada bayi dan anak. In: Soepardi EA, Iskandar N, Bashiruddin J, Restuti JD, editors. Buku ajar ilmu penyakit HT.6th ed. Jakarta: Universitas Indonesia, 2007; p. 31A2.
22. Cox LC. Infant assesment: Developmental and age related consideration. In: JacobsonJT, editor. The auditory brainstem response. California: College Hill Press Inc, 1985; p. 297-316.
23. Lonsbury-Martin BL. Introduction to otoacoustic emissions. Am) Otol. 1994;15,1-3.
24. Boo NY, Oakes M, Lye MS, Said H. Risk factors associated with hearing loss in tenn neonates with hyperbilirubinaemia. J Trop Pediatr. 1994;40,194-7.
25. Abdillah F. Gambaran DPOAE & Automated ABR neonates cukup bulan sesuai masa kehamilan sehat dengan hiperbilirubinemia. [Thesis]. Jakarta : University of Indonesia; 2007.
26. Weisiger RA, Ostrow JD, Koehler RK, Webster CC, Mukerjee P, Pascolo L, et al. Affinity of Human Serum Albumin for Bilirubin Varies with Albumin Concentration and Buffer Composition: Result of a novel ultrafiltration method. J Biol Chem. 001;276,29953-60.
Authors who publish with this journal agree to the following terms:
Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.