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Diagnostic and predictive value of auditory evoked responses in preterm infants: I. Patient characteristics and
J W Pasman1, J J Rotteveel, B Maassen
1Department of Clinical Neurophysiology, University Hospital, Nijmegen, The Netherlands.
Insights
This study assessed auditory evoked responses in preterm infants, finding that high-risk infants had poorer neurodevelopmental outcomes. However, some low-risk infants also showed unfavorable outcomes, suggesting specific impairments rather than widespread issues.
Area of Science:
- Neuroscience
- Developmental Pediatrics
- Audiology
Background:
- Neonatal auditory evoked responses (AERs) are crucial for assessing auditory pathway development.
- Preterm infants face higher risks of neurodevelopmental issues, including those affecting auditory processing.
- Understanding the predictive value of neonatal AERs is vital for early intervention.
Purpose of the Study:
- To evaluate the diagnostic and predictive value of neonatal brainstem, middle latency, and cortical auditory evoked responses (AERs).
- To correlate these neonatal AERs with neurodevelopmental outcomes at 5 years of age in preterm infants.
- To identify risk factors and patterns associated with unfavorable neurodevelopmental outcomes in preterm populations.
Main Methods:
- Auditory evoked responses (brainstem, middle latency, cortical) were recorded in 81 preterm infants during the neonatal period.
- A control group of 18 healthy term infants was included for comparison.
- Neurodevelopmental outcome at 5 years was assessed using neurologic and neuropsychologic evaluations, including IQ testing.
Main Results:
- Neuropsychologic testing revealed the highest IQ scores in term infants, intermediate scores in low-risk preterm infants, and the lowest scores in high-risk preterm infants.
- The intermediate IQ scores in the low-risk preterm group were influenced by a subgroup with significantly lower test scores.
- Post hoc analysis identified 12 low-risk preterm infants with unfavorable outcomes; the remaining low-risk infants showed outcomes comparable to term infants.
Conclusions:
- The overall unfavorable outcome in the low-risk preterm group appears to be driven by moderate to severe impairments in a few individuals, not slight impairments across the majority.
- Neonatal auditory evoked responses show potential as predictors of neurodevelopmental outcomes in preterm infants.
- Targeted follow-up and intervention may be beneficial for specific subgroups of preterm infants, even those initially classified as low-risk.
Abstract:
The diagnostic and predictive value of brainstem, middle latency, and cortical auditory evoked responses, obtained in the neonatal period, in 81 preterm infants was assessed in relation to neurodevelopmental outcome. Eighteen healthy term infants served as a control group. In this report the patient characteristics and neurodevelopmental outcome are presented. The preterm infants were neonatally classified according to risk category and gestational age. At 5 y of age the neurodevelopmental outcome was assessed based on neurologic and neuropsychologic evaluations. The neuropsychologic test results showed the highest IQ scores in term infants, intermediate IQ scores in low risk preterm infants, and lowest IQ scores in high risk preterm infants. The intermediate IQ scores in the low risk preterm group were due to significantly lower test scores in a small subgroup of low risk preterm infants. In a post hoc analysis 12 low risk preterm infants with an unfavorable outcome could be identified. The neuropsychologic test results of the remaining low risk infants showed no clear differences compared with the term infants. The results suggest that the unfavorable outcome of the low risk preterm group as a whole is due to moderate to severe impairment of the few, rather than slight impairment of the majority.