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[The study of factors affecting ABR in high risk newborn infants]
E Castello1, A Tedeschi, S Brera
1Dipartimento Regionale Testa Collo, Ospedale S. Martino, Genova.
Insights
Auditory Brainstem Response (ABR) testing revealed delayed brainstem auditory pathway function in at-risk newborns. These findings highlight the sensitivity of central auditory pathways to damage in infants with various risk factors.
Area of Science:
- Neuroscience
- Pediatrics
- Audiology
Background:
- Newborn infants at risk for developmental issues require careful auditory pathway assessment.
- Auditory Brainstem Response (ABR) is a key diagnostic tool for evaluating hearing and neural pathway function in neonates.
Purpose of the Study:
- To investigate auditory pathway function in newborns with various risk factors using ABR.
- To identify specific risk factors and pathologies associated with altered ABR parameters in neonates.
Main Methods:
- Auditory Brainstem Response (ABR) testing was performed on 78 at-risk newborns and 20 normal infants.
- Statistical analysis, including t-tests and logistic regression, compared ABR results between groups and identified influential risk factors.
Main Results:
- At-risk infants showed significantly increased latency in waves V and III, and inter-waves I-V and III-V, indicating brainstem pathway alterations.
- Cochlear and acoustic nerve function (wave I and inter-wave I-III) remained normal in the at-risk group.
- Birth weight, chronological age, and gestational age were significant factors influencing ABR alterations, alongside specific pathologies like Albers-Schomberg syndrome and HIV infection.
Conclusions:
- Central auditory pathways in newborns are more susceptible to damage from risk factors than the cochlea or acoustic nerve.
- Specific neonatal pathologies and prematurity significantly impact auditory brainstem pathway development and function.
- ABR is crucial for early detection of auditory pathway dysfunction in high-risk infant populations.
Abstract:
A.B.R. was employed to examine auditory pathways in a group of 78 newborn infants at risk and one of 20 normal infants. The impaired newborn group suffered of various risk factors or pathologies: 20 premature infants, 12 undersize (small for date), 12 with breathing distress, 11 hiv positive, 5 with neonatal jaundice, 4 suffered of convulsion, 4 at risk for hereditary deafness, 4 born by mothers with mellitus diabetes, 2 with dolichocefalia, 1 with the Albers-Schomberg syndrome, 1 with congenital heart disease and 1 with congenital glycogenosis. The results of A.B.R. of the risk group were compared statistically employing the "t Student's test" with those of the group of normal infants. The influence of risk factors in the first group on alterated A.B.R. parameters was then examined using a step-by-step logistic regression analysis method. The result showed a significant increase in a latency of waves V and III and inter-waves I-V and III-V in risk infants, while wave I and I-III internals were normal. These findings appear to demonstrate that in infants at risk, brainstem acoustic pathways are more sensitive to damage than the cochlea and acoustic nerve. This could be explained by the different degree of maturation that exists between the central acoustic pathways and the coclea and acoustic nerve. Analysis of the influence of pathologies and risk factors on A.B.R. indicate that birth weight followed by chronological age and length of the gestation period are significant in the development of A.B.R. alterations. The Albers-Schomberg syndrome, dolicocephalia, microcephalia, congenital glicogenosys, hiv infection, breathing difficulty and neonatal jaundice proved to be the main pathologies responsible for bringing about A.B.R. alterations.