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Published on: November 20, 2015
Effects of neurodevelopmental risk factors on brainstem maturation in premature infants
L Borenstein-Levin1,2, R Taha3, A Riskin3,4
1Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel. liron.boren@gmail.com.
Insights
Male sex is linked to delayed auditory pathway maturation in premature infants, while conditions like IVH/PVL, BPD, and SGA may accelerate it. Auditory brainstem response (ABR) testing helps assess this maturation.
Area of Science:
- Neuroscience
- Pediatrics
- Auditory Neuroscience
Background:
- Auditory brainstem-evoked responses (ABR) measure interpeak latencies (IPL), reflecting auditory pathway conduction time and maturation.
- Premature infants face neurodevelopmental risks that may impact auditory pathway development.
- Understanding these effects is crucial for early intervention and monitoring.
Purpose of the Study:
- To investigate the influence of various neurodevelopmental risk factors on auditory pathway conduction time in normal-hearing premature infants.
- To analyze the relationship between risk factors and interpeak latencies (IPL) at term postmenstrual age (PMA).
Main Methods:
- Retrospective analysis of 239 premature infants.
- Recorded interpeak latencies (IPL) from auditory brainstem-evoked responses (ABR) tests.
- Collected demographic data and documented risk factors like gestational age, birth weight, sex, and medical conditions.
Main Results:
- Univariate analysis showed sex, PMA at ABR, SGA, IVH/PVL, and ventilation days significantly affected IPLs.
- Multivariable analysis identified male sex and earlier PMA at testing as independent factors for prolonged IPLs.
- Bronchopulmonary dysplasia (BPD), IVH/PVL, and SGA were associated with shortened IPLs, indicating accelerated maturation.
Conclusions:
- Male sex is associated with delayed auditory brainstem maturation.
- Conditions such as IVH/PVL, BPD, and SGA may be linked to accelerated auditory pathway maturation.
- Corrected age at ABR testing is significant for assessing auditory maturation in preterm infants.
Background:
Interpeak latencies (IPL), as measured by the auditory brainstem-evoked responses (ABR) test, represent the conduction time, and therefore the maturation of the brainstem auditory pathway. We aimed to study the effect of various risk factors for the neurodevelopmental delay on the conduction time in the auditory pathway among normal hearing premature infants, at term postmenstrual age (PMA).
Methods:
Retrospective analysis of 239 premature infants (gestational age 32.5 ± 2.1 weeks, birth weight 1827 ± 483 g). Interpeak latencies, demographic data, and risk factors were recorded.
Results:
Sex, PMA at ABR test, being small for gestational age (SGA), intraventricular hemorrhage (IVH) or periventricular leukomalacia (PVL), and days of invasive ventilation were found to significantly affect the IPL's in the auditory pathway in a univariate analysis. Multivariable regression analysis revealed that male sex and less advanced PMA at the examination were independent factors associated with prolonged IPL's, while bronchopulmonary dysplasia, IVH or PVL and being SGA shortened the IPL's. Non-invasive mechanical ventilation, did not affect the caudal part of the auditory pathway, despite its high noise level.
Conclusions:
Among various risk factors for the neurodevelopmental delay, male sex was associated with delayed, while IVH or PVL, BPD and SGA could be associated with accelerated auditory brainstem maturation.
Impact:
Auditory brainstem-evoked response (ABR) test, among normal hearing infants, can serve as a clinical tool to assess brainstem auditory maturation. Different neurodevelopmental risk factors could have different effects on the maturity of the auditory pathway. Male sex is significantly associated with prolonged interpeak latencies (IPL) among preterm and term infants, while intraventricular hemorrhage or periventricular leukomalacia, bronchopulmonary dysplasia, and being small for gestation age may be associated with shortened IPL The corrected age at ABR testing is of significance, among preterm and term infants.
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