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Published on: July 1, 2015
In utero iron status and auditory neural maturation in premature infants as evaluated by auditory brainstem response
Sanjiv B Amin1, Mark Orlando, Ann Eddins
1Department of Pediatrics, Division of Neonatology, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA. Sanjiv_Amin@urmc.rochester.edu
Insights
Premature infants with low cord ferritin (CF) levels, indicating in utero iron deficiency, show delayed auditory neural maturation. This suggests iron status impacts early auditory development in vulnerable newborns.
Area of Science:
- Neonatal Medicine
- Neuroscience
- Pediatric Audiology
Background:
- In utero iron status is crucial for infant development.
- Cord ferritin (CF) serves as an indicator of fetal iron reserves.
- Auditory neural maturation is a critical developmental milestone in premature infants.
Purpose of the Study:
- To investigate the association between cord ferritin concentration and auditory neural maturation in premature infants.
- To compare auditory neural maturation in premature infants with and without latent iron deficiency at birth.
Main Methods:
- Prospective cohort study of 80 premature infants (27-33 weeks gestational age).
- Categorized infants based on cord ferritin levels: latent iron deficiency (11-75 ng/mL) vs. normal iron status (>75 ng/mL).
- Assessed auditory brainstem evoked response (ABR) within 48 hours of birth.
Main Results:
- 35 out of 80 infants presented with latent iron deficiency.
- Infants with latent iron deficiency exhibited significantly prolonged absolute wave latencies (I, III, V) in ABR.
- A decreased frequency of mature ABR waveforms was observed in the iron-deficient group.
Conclusions:
- In utero latent iron deficiency is linked to abnormal auditory neural maturation in premature infants.
- Findings highlight the importance of adequate iron status for proper auditory pathway development in neonates.
Objective:
To determine whether cord ferritin (CF) concentration, an index of in utero iron status, is associated with auditory neural maturation in premature infants.
Study Design:
A prospective cohort study was performed to compare auditory neural maturation in infants with latent iron deficiency (CF 11-75 ng/mL) and infants with normal iron status (CF > 75 ng/mL) at birth. Our inclusion criteria were infants of 27-33 weeks gestational age who were admitted to the neonatal intensive care unit between July 2007 and November 2008 within 12 hours after birth and had cord blood collected. Infants with TORCH infections (toxoplasmosis, other infections, rubella, cytomegalovirus infection, and herpes simplex), chromosomal disorders, craniofacial anomalies, culture-proven sepsis, and/or unstable conditions were excluded. CF level was measured using a chemiluminescence immunoassay method. Bilateral monaural auditory brainstem evoked response (ABR) was assessed using 80-dB nHL click stimuli at a repetition rate of 29.9/seconds within 48 hours after birth.
Results:
Of the 80 infants studied, 35 had latent iron deficiency. After controlling for confounders, the infants with latent iron deficiency had significantly prolonged absolute wave latencies I, III, and V and decreased frequency of mature ABR waveforms compared with the infants with normal iron status.
Conclusion:
Premature infants with in utero latent iron deficiency have abnormal auditory neural maturation compared with infants with normal in utero iron status.
