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Published on: July 1, 2015
Association of Cord Ferritin Levels with Brain Stem Evoked Response Audiometry in Newborns
Vanita Sarin1, Preeti Malhotra2, Maninder Jeet Kaur2
1Department of Otorhinolaryngology, Sri Guru Ram Das Institute of Medical Sciences and Research, Amritsar, India.
Insights
Umbilical cord ferritin levels significantly impact neonatal brainstem auditory evoked response, affecting myelination and neurological development. Monitoring cord ferritin can help detect early issues in brain maturation.
Area of Science:
- Neonatal Neurology
- Iron Metabolism
- Auditory Neurophysiology
Background:
- Iron is crucial for neurological development, particularly myelin formation and neurotransmitter synthesis.
- Cord ferritin levels accurately reflect in-utero iron stores.
- Brainstem Evoked Response Audiometry (BERA) assesses auditory pathway function.
Purpose of the Study:
- To investigate the association between umbilical cord ferritin levels (CFL) and Brainstem Evoked Response Audiometry (BERA) outcomes in neonates.
- To determine if lower CFL impacts auditory pathway maturation.
Main Methods:
- Prospective observational study of 100 neonates in North India.
- Measurement of umbilical cord ferritin levels, categorizing neonates into low (<75 ng/ml) and adequate (>75 ng/dl) groups.
- Performance of BERA on all neonates to assess auditory pathway function.
Main Results:
- Neonates with lower CFL exhibited significantly prolonged absolute peak latencies (waves I, III, V) and interpeak latencies (III-V) in BERA.
- Negative correlations were observed between CFL and BERA latencies, indicating impaired neural conduction with lower iron stores.
- CFL showed significant negative correlation with maternal hemoglobin, neonatal birth weight, and cord hematocrit.
Conclusions:
- Umbilical cord ferritin levels significantly influence neonatal BERA parameters, suggesting altered myelination and brain maturation.
- Lower CFL is associated with delayed auditory pathway maturation, highlighting the importance of iron status.
- Routine monitoring of CFL in neonates is recommended for early detection of potential neurological compromises.
Abstract:
Iron is an important nutrient and it plays a pivotal role in myelin formation and neurotransmitter synthesis, thus contributing to normal neurological activity. Ferritin is a reliable indicator of the tissue iron stores and in-utero stores can be well measured by cord ferritin levels. The objective of this study was to evaluate the effects of umbilical cord ferritin levels (CFL) on the brain stem evoked response audiometry (BERA) This prospective observational study was conducted in a tertiary care centre of North India with a sample size of 100 inborn neonates. After evaluation of the umbilical cord ferritin levels the study cohort was divided into Group A( UCF<75ng/ml) and Group B(UCF>75ng/dl). All subjects were subjected to BERA. A detailed analysis of CFL and BERA was done and statistically analysed. Neonates in group B had significantly prolonged absolute peak latency of wave I, III and V and interpeak latency of wave III-V when compared to group A. The Pearson correlation also showed negative correlation of CFL with absolute peak latency of wave I, III, and V and interpeak latency of wave III-V. Among the maternal and neonatal variables, highly significant correlation was noted between absolute latency of wave I, III and V, CFL and cord hematocrit. The Pearson correlation showed negative correlation of absolute peak latency of wave I, III and V with maternal haemoglobin (Hb), neonatal birth weight, CFL,s and cord hematocrit values. A negative Pearson correlation was noted between interpeak latency of wave III-V with neonatal birth weight and cord hematocrit level, interpeak latency of wave I-V with neonatal birth weight and between interpeak latency of wave I-III with cord hematocrit values. CFL's significantly affect the absolute peak latency of wave I, III and V and it also affects the interpeak latency of wave III-V. This may be attributed to slow conduction time secondary to altered myelination. CFL's should be considered as a routine protocol in neonates to detect early compromises in the process of myelination and brain maturation.
