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Audiologic assessment of extremely low birth weight infants: a preliminary report
L W Doyle1, E Keir, W H Kitchen
1Department of Obstetrics and Gynaecology, University of Melbourne, Parkville, Australia.
Insights
Extremely low birth weight children often experience auditory issues, including hearing impairment and problems with auditory memory and sound differentiation. High bilirubin levels in newborns are linked to these auditory deficits and later cognitive challenges.
Area of Science:
- Pediatrics
- Audiology
- Neonatology
Background:
- Extremely low birth weight (ELBW) infants face numerous health challenges.
- Auditory function is critical for development, yet ELBW survivors are at risk for hearing impairments.
Purpose of the Study:
- To comprehensively assess auditory function in ELBW children at 8 years of age.
- To identify specific auditory deficits and their correlation with neonatal factors and long-term outcomes.
Main Methods:
- Auditory assessment of 42 ELBW survivors (birth weight < 1000 g) at 8 years old.
- Analysis of perinatal data, including maximum newborn bilirubin concentrations and intensive care requirements.
- Comparison with normative data for specific auditory skills.
Main Results:
- 9.5% had sensorineural hearing impairment, linked to higher neonatal bilirubin levels and impacting verbal ability.
- 11.9% had conductive hearing impairment with no significant outcome differences.
- 57.1% exhibited figure/ground differentiation problems, significantly higher than controls.
- 47.6% had short-term auditory memory deficits, associated with higher bilirubin and reduced intelligence/reading ability.
Conclusions:
- ELBW children exhibit a high prevalence of auditory processing difficulties beyond simple hearing impairment.
- Neonatal hyperbilirubinemia is a significant risk factor for sensorineural hearing loss and auditory memory problems.
- Auditory deficits in ELBW survivors can impact cognitive development and academic achievement, necessitating early monitoring and intervention.
Abstract:
The aim of this study was to assess all relevant aspects of auditory function, including acuity and perception, of a cohort of extremely low birth weight (< 1000 g) children who survived to 8 years of age; 42 of the 59 consecutive survivors born over a 4-year period from January 1, 1977, had a full auditory assessment. Of the 42 children, 4 (9.5%) had a sensorineural hearing impairment, 5 (11.9%) had a conductive hearing impairment, 24 (57.1%) had figure/ground differentiation problems, and 20 (47.6%) had a short-term auditory memory problem. The 4 children with sensorineural hearing impairments had had significantly higher maximum concentrations of bilirubin in the newborn period (median 167 mumol/L vs 138 mumol/L and had required more intensive care; at 8 years of age they were significantly disadvantaged in verbal ability. The 5 children with conductive hearing impairments were not significantly different on any perinatal or other 8-year outcome variables. The proportion with figure/ground differentiation problems (57.1%) was significantly higher than in a normative population (11.7%, chi 2 = 24.2). Extremely low birth weight children with figure/ground differentiation problems were more likely to be restless in the classroom (45.0% [9/20]) than those without these problems (16.7% [2/12]), but the difference was not statistically significant (chi 2 = 2.7). Children with short-term auditory memory problems had significantly higher maximum bilirubin concentrations in the newborn period (median 152 mumol/L vs 137.5 mumol/L). At 8 years of age they had significantly reduced intelligence and reading ability.(ABSTRACT TRUNCATED AT 250 WORDS)