How should hyperbilirubinemia be considered in the definition of the hearing screening protocol for neonates at risk?

ABSTRACT

Purpose

To analyze hyperbilirubinemia as an indicator for the definition of risk protocol in newborn hearing screening (NHS) and in auditory monitoring in full-term and preterm neonates.

Methods

This is an observational, cross-sectional and retrospective study. A total of 554 children born in a public maternity hospital were included and divided into two groups: (G1) with 373 full-terms neonates; (G2) with 181 preterm neonates. Data were collected from the participant’s medical records to obtain information regarding the result of the NHS, performed by recording the automated auditory brainstem response (AABR), birth conditions, clinical characteristics, interventions performed, and results of the first test of total bilirubin (TB) and indirect bilirubin (IB) as well as the peak of TB and IB. A descriptive statistical analysis of the results was performed, and the level of significance adopted was 5%.

Results

On the NHS test, quotes of retest referral rates were smaller in G1 when compared to G2. There was no significant difference between the groups regarding type of delivery, gender, presence of Rh and ABO incompatibility, G6PD enzyme deficiency, and performance of phototherapy. TB and IB levels at the first exam and at peak time did not differ between neonates with “pass” and “fail” results on the NHS test in both groups.

Conclusion

Bilirubin levels in the neonatal period below the recommended values for indication of exchange transfusion are not directly related to the “fail” result on the NHS tests in term and preterm neonates.

Keywords:
Hyperbilirubinemia; Jaundice; Hearing Loss; Bilirubin; Infant