The Correlation Of Severe Neonatal Hyperbilirubinemia And Hearing Damage

Objective:To investigate the risk factors and follow-up of severe neonatal hyperbilirubinemia and hearing damage in newborn.Methods:This was a retrospective study of 106 newborns that had severe neonatal hyperbilirubinemia in neonatal ward of Shanghai Children’s Medical Center from June 2015 to June 2016.According to the level of bilirubin,we divided them into three group: severe neonatal hyperbilirubinemia(TSB peak range of 342 μmol/L~427.5μmol/L),very severe neonatal hyperbilirubinemia(TSB peak range of 427.5μmol/L~513μmol/L),fatal neonatal hyperbilirubinemia(TSB peak is higher than 513μmol/L).Automatic brainstem auditory evoked potential(AABR)was used to evaluate the hearing ability of children in hospital,while those who got abnormal results would undergo diagnostic test of auditory brainstem response in three months old.We contacted to everyone to trace the situation of auditory behavioral response.Results: It was total 106 newborns in three groups: thirty-three cases(33/106,31.13%)with abnormal at hearing screening in hospital,twenty-two cases(22/86,25.58%)with abnormal in severe neonatal hyperbilirubinemia,nine cases(9/16,56.25%)with abnormal in very severe neonatal hyperbilirubinemia,2 cases(2/4,50.00%)with abnormal in fatal neonatal hyperbilirubinemia.The difference was statistically significant(P<0.05).ALL thirty-three patients who had not pass AABR in hospital came to undergo diagnostic test of auditory brainstem response through regular education by a specially assigned person.Two children were diagnosed mild hearing damage.One of them was considered being caused by tympanitis.All children had good situation of auditory behavioral response in follow-up.Conclusions: Severe neonatal hyperbilirubinemia is one of the high risk factors of hearing damage in neonates.The morbidity of hearing damage was more obvious with the increase of bilirubin level.The false-positive results of AABR in hospital may indicate that the hearing damage caused by severe neonatal hyperbilirubinemia is reversible.It also suggested that the follow-up plan should be improved.All patients passed the auditory behavioral response.It speculated that the hearing damage caused by severe neonatal hyperbilirubinemia may have no obvious effect on children in daily life.However this method depended on the subjective judgment of parents and seemed to be rough.We still needed to carry out the long term follow-up of children who were abnormal in diagnostic test of auditory brainstem response.