The outcomes of an audiological management programme for neonates with hyperbilirubinaemia.
Moleboge M Matshete, Samantha Govender, Sam T Ntuli
PMID 39494637WHAT IT FOUND
Neonates with jaundice showed more hearing abnormalities when tested with both ABR and DPOAE than with either test alone.
ABR detected significantly more cases than DPOAE, especially in infants with bilirubin levels above 10 mg/dL. Using both tests together improved the accuracy of identifying hearing loss.
Key findings
01The ABR test identified more abnormal ears than the DPOAE test alone, and using both tests together resulted in higher disease accuracy than using either test in isolation.
02Neonates with serum bilirubin levels of 10 mg/dL or higher had a significantly higher rate of abnormal ABR results compared to those with lower levels, suggesting ABR is particularly important for this group.
03Final diagnoses revealed that central lesions were the most common finding, followed by peripheral lesions, with a significant portion of infants having normal hearing.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The study had a small sample size (40 neonates) and was conducted at a single centre, which limits generalisability. The design was cross-sectional, so it cannot establish causality between bilirubin levels and long-term hearing outcomes. The high prevalence of concomitant conditions like prematurity and low birth weight in the sample makes it difficult to isolate the specific effect of hyperbilirubinaemia on hearing loss. The study did not include a control group of neonates without hyperbilirubinaemia, so comparisons are limited to within-subject test performance.
Declared interests
The authors declared no conflicts of interest. The study was approved by the Sefako Makgatho University Research Ethics Committee.
The easy way to misread this
Do not assume that a pass on DPOAE screening rules out hearing loss in jaundiced neonates. This study found that ABR detected abnormalities in many ears that passed DPOAE, indicating that DPOAE alone can miss neural hearing losses associated with hyperbilirubinaemia.