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Type of initial brainstem auditory evoked potentials (BAEP) impairment and risk factors in premature infants
C Ferber-Viart1, T Morlet, S Maison
1Laboratoire de Physiologie Sensorielle, Centre Hospitalier Lyon-Sud, Pierre Bénite, France.
Insights
Over half of premature infants showed abnormal brainstem auditory evoked potentials (BAEPs), with hypoxia being a significant risk factor. Certain risk factors correlated with specific types of auditory pathway damage.
Area of Science:
- Neonatal audiology
- Neurophysiology
- Pediatric neurology
Background:
- Premature infants are at increased risk for auditory pathway abnormalities.
- Brainstem auditory evoked potentials (BAEPs) are crucial for assessing auditory function in neonates.
- Understanding risk factors associated with BAEP impairments is vital for early intervention.
Purpose of the Study:
- To investigate the prevalence and types of BAEP impairments in premature infants.
- To identify correlations between specific risk factors and patterns of auditory pathway damage.
- To determine the incidence of potentially handicapping hearing loss in this population.
Main Methods:
- Recording of BAEPs in 89 premature infants (34-52 weeks corrected age).
- Analysis of seven risk factors: low birth weight (<1500g), hypoxia, neurological damage, fetal pathology, malformations, ototoxic drugs, and exchange transfusion.
- Classification of BAEP impairment into endocochlear, transmission, or retrocochlear damage.
Main Results:
- 52.8% of infants exhibited abnormal BAEPs.
- Hypoxia was associated with the highest percentage of BAEP impairment (63.3%).
- Transmission impairment linked to low birth weight, hypoxia, and ototoxic drugs; endocochlear damage associated with ototoxic drugs and exchange transfusion.
- Higher birth weight correlated with more endocochlear damage, while lower birth weight correlated with more transmission damage.
- Male infants showed more frequent and retrocochlear BAEP impairments; females showed more endocochlear impairments.
- 11.2% of infants had endocochlear damage, indicating potentially handicapping hearing loss.
Conclusions:
- Premature infants exhibit a high rate of BAEP abnormalities, with varying types of damage linked to specific risk factors.
- Hypoxia, low birth weight, ototoxic drug exposure, and exchange transfusions are significant contributors to auditory pathway dysfunction.
- Endocochlear damage, a potentially handicapping hearing loss, is observed in a notable percentage of premature infants, necessitating further investigation and monitoring.
Abstract:
Brainstem auditory evoked potentials (BAEPs) were recorded in 89 premature infants aged between 34 and 52 weeks. 47.2% had normal and 52.8% abnormal BAEPs in at least one ear. Seven risk factors were taken into account: birth weight lower than 1500 g, hypoxia, neurological damage, fetal pathology, associated malformation, the use of ototoxic drugs, and exchange transfusion. The type of BAEP impairment was defined as either endocochlear, transmission or retrocochlear damage. Percentage BAEP impairment was higher in case of hypoxia (63.3%) but remained similar whether the other risk factors were present or absent. Transmission impairment was more frequent in case of birth weight lower than 1500 g, hypoxia or ototoxic drug administration; Endocochlear damage occurred more frequently when ototoxic drugs had been used or exchange transfusion performed. When birth weight was lower than 1500 g, transmission damage was more frequent than when birth weight was higher than 1500 g. In contrast, endocochlear damage was more frequent when birth weight was higher than compared with lower than 1500 g. In male infants, BAEP impairment was more frequent and more often of retrocochlear type than in female infants. BAEP impairment was more frequently of endocochlear type in female compared to male infants. Among the 89 premature infants recorded, 11.2% has endocochlear damage corresponding to potentially handicapping hearing loss. These results are discussed with reference to the literature.