الفهرس 
Neonatal JaundiceOnly 14 pages are availabe for public view
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Abstract
This prospective case control study was designed to determine the effect of neonatal hyperbilirubinemia on auditory brainstem response (ABR) and evaluate the effect of treatment of hyperbilirubinemia on ABR findings.
Patients and Methods: This study was performed on newborns with pathologic hyperbilirubinemia. The inclusion criteria were healthy term and near term (35 - 37 weeks) newborns with pathologic hyperbilirubinemia with serum bilirubin values of >13 mg/dL.
Inclusion criteria:
1. Fetomaternal blood group incompatibility.
2. Rh incompatibility.
3. History of previous sibling with significant hyperbilirubinemia.
4. Onset of jaundice before 24 hours of age.
5. A rise in serum bilirubin levels of over 0.5 mg/dl/hour.
6. Infant of diabetic mother.
Exclusion criteria:
1. Syndromes associated with hearing loss as: Waardenberg Syndrome, Pendred Syndrome, and Usher Syndrome...etc.
2. Family history of hereditary childhood sensorineural hearing loss.
3. Craniofacial abnormalities.
4. Congenital infections such as cytomegalovirus, rubella, syphilis, herpes simplex and toxoplasmosis.
5. Bacterial meningitis.
6. Birth weight less than 1500 grams.
7. Ototoxic medications use like amino glycosides, loop diuretics etc.
8. Low Apgar scores of 0–4 at 1 min or 0–6 at 5 min.
9. Mechanical ventilation lasting ≥5 days.
A total of 30 newborns with hyperbilirubinemia met the enrolment criteria as the case group and 20 healthy newborns as the control group, who werechosen from Neonatal Intensive Care unit and Maternity department of AL Zahraa Hospital of Al-Azhar University respectively. ABR was performed on both groups. The evaluated variable factors were latency time, inter peak intervals time, and loss of waves.
The newborns were tested with ABR before and after treatment (phototherapy and or exchange transfusion).They were naturally sleeping with no sedation.
Results: The mean latencies of waves I, III and V of ABR were significantly higher in the pathologic hyperbilirubinemia group compared with the controls (P < 0.001). In addition, the mean interpeak intervals (IPI) of waves I-III, I-V and III-V of ABR were significantly higher in the pathologic hyperbilirubinemia group compared with the controls (P < 0.001).After treatment of jaundiced newborns; a marked improvement in hearing was noticed where total reversibility to normal thresholds (normal hearing) was displayed by 23(77.00%) of jaundiced neonates in the right ear and 25 (83.30%) of jaundiced neonates in the left ear out of 30 cases, while the remaining 7 (23.00%) and 5 (16.70%) of jaundiced neonates displayed partial reversibility (mild to moderate hearing loss)in the right and left ears respectively, which shows that hearing affection may be transient.
Conclusions: Pathologic hyperbilirubinemia causes acute disorder on brain stem function; therefore, early diagnosis of neonatal jaundice for prevention of bilirubin neurotoxic effects is essential.
Recommendations: We recommend early di¬agnosis and treatment of neonatal jaundice and performing ABR for screening of bilirubin neurotoxicity in all cases with hyperbilirubinemia.