The effects of early and late preterm birth on brainstem and middle-latency auditory evoked responses in children with normal neurodevelopment
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J W Pasman1, J J Rotteveel, R de Graaf
1Department of Clinical Neurophysiology, University Hospital, Nijmegen, the Netherlands.
Insights
Preterm birth impacts auditory pathway maturation, leading to longer auditory evoked response (ABR and MLR) latencies in preterm infants compared to term infants, even with normal neurodevelopmental outcomes.
Area of Science:
- Neuroscience
- Developmental Pediatrics
- Auditory Neuroscience
Background:
- Preterm birth can affect the maturation of the central auditory pathway.
- Auditory evoked responses (AERs), including auditory brainstem responses (ABRs) and middle latency responses (MLRs), are key indicators of auditory pathway function.
- Understanding the long-term effects of preterm birth on auditory development is crucial for early intervention.
Purpose of the Study:
- To investigate the effect of preterm birth on the maturation of ABR and MLR in infants.
- To compare auditory pathway maturation between early preterm, late preterm, and term infants with normal neurodevelopmental outcomes.
- To explore potential reasons for observed differences in AERs.
Main Methods:
- Auditory brainstem responses (ABRs) and middle latency responses (MLRs) were recorded at 40 and 52 weeks conceptional age (CA) and at 5 years of age.
- Neurological and neuropsychological evaluations were conducted at 5 years of age.
- Preterm infants were categorized into early and late preterm groups; only those with normal neurodevelopmental outcomes were included.
Main Results:
- Late preterm infants showed significantly longer ABR latencies and interpeak latencies at 52 weeks CA compared to term infants.
- At 5 years, late preterm infants still exhibited longer ABR latencies compared to early preterm infants.
- MLR latencies were longer in preterm groups compared to the term group at earlier CA, and term infants had higher MLR amplitudes at 5 years.
Conclusions:
- Delayed myelination and potential middle ear effusions likely contribute to ABR differences in preterm infants.
- The auditory pathway's vulnerability between 30-34 weeks CA may explain differences between early and late preterm infants.
- MLR variations suggest differing maturation rates of primary and nonprimary components in preterm infants.
Abstract:
In preterm and term infants, brainstem and middle latency auditory evoked responses (ABR and MLR) were obtained at 40 and 52 weeks conceptional age (CA) and at 5 years of age. A neurological and neuropsychological evaluation was performed at 5 years of age. To study the effect of preterm birth on the maturation of the ABR and MLR, the preterm infants were divided into early and late preterm groups. Only children with a normal neurodevelopmental outcome at 5 years of age were entered into the study. For ABR, the late preterm group showed significantly longer mean latencies IIc, III, V, and Vc when compared with the term group at 52 weeks CA. There was a trend to longer ABR latencies I in the early preterm group compared with the term group. At 52 weeks CA, the late preterm group showed longer mean interpeak latencies III-I and V-I when compared with the term as well as the early preterm group. At 5 years, the late preterm group showed significantly longer mean ABR latencies IIc and III when compared to the early preterm group. For MLR, the early preterm group showed significantly longer mean latencies of MLR component PO when compared with the term group at 40 weeks CA. At 52 weeks, the late preterm group also had longer mean MLR latencies P0 than the term group. At 5 years of age, the term group showed higher mean peak-to-peak amplitudes Na-P0 than the early as well as the late preterm group. To a large extent, the ABR results support the hypothesis that middle ear effusions in combination with retarded myelination of the central auditory pathway are responsible for the ABR differences found between term and preterm infants with a normal neurodevelopmental outcome at 5 years of age. The longer latencies and interpeak latencies found in late preterm infants when compared with early preterm infants might be explained by an augmented vulnerability of the auditory pathway between 30 and 34 weeks CA. The MLR differences found between term and preterm infants might be explained by a difference in the maturation of primary and nonprimary MLR components.