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Hyperbilirubinemia Requiring Exchange Transfusion as a Risk Factor for Later-Onset Hearing Loss

Susan Wiley1, Vivian Kaul2, Oliver F Adunka3,4

  • 1Cincinnati Children's Hospital Medical Center/University of Cincinnati, Cincinnati, OH.

Journal of Early Hearing Detection and Intervention
|March 4, 2025
PubMed

Insights

Hyperbilirubinemia requiring exchange transfusion is a risk factor for childhood hearing loss. Infants with this condition should undergo Automated Auditory Brainstem Response screening and continued monitoring for optimal outcomes.

Area of Science:

  • Pediatric Audiology
  • Neonatal Care
  • Evidence-Based Medicine

Background:

  • The Joint Committee on Infant Hearing (JCIH) previously identified hyperbilirubinemia requiring exchange transfusion as a risk factor for childhood hearing loss.
  • This review critically examines the evidence supporting the JCIH recommendation.

Purpose of the Study:

  • To evaluate the strength of evidence linking hyperbilirubinemia requiring exchange transfusion to childhood hearing loss.
  • To inform clinical practice guidelines for hearing screening and monitoring in at-risk infants.

Main Methods:

  • A comprehensive literature search was conducted using PubMed with keywords 'hyperbilirubinemia' and 'hearing loss'.
  • Seventy-seven original papers were identified, with 44 undergoing full review and 21 being graded for evidence quality.
  • Recommendations were based on graded evidence and expert consensus.

Main Results:

  • A moderate level of evidence supports hyperbilirubinemia requiring exchange transfusion as a risk factor for elevated hearing thresholds in infants and young children.
  • Automated Auditory Brainstem Response screening is recommended for this infant population.
  • The net benefit of these interventions is moderate to substantial.

Conclusions:

  • Close monitoring of hearing, speech, and language milestones is crucial for infants with hyperbilirubinemia requiring exchange transfusion, even if they pass newborn hearing screening.
  • Early detection and intervention can lead to improved developmental outcomes.
Abstract

Keywords:
hyperbilirubinemia requiring exchange transfusionliterature reviewnewborn hearing screening

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