Clinical Study Of Neonatal Hyperbilirubinemia And Hearing Loss In NICU

Objective: To investigate the correlation between neonatal hyperbilirubinemia and hearing loss in NICU,the effect of elevated TSB on hearing loss and follow-up of hearing loss neonates,in order to provide evidence for diagnosis and intervention.Methods: A total of 368 neonates diagnosed as neonatal hyperbilirubinemia(NB)was selected as case group from NICU in Shengjing Hospital of China Medical University from October 2018 to June 2020.These neonates were divided into two groups according to the level of TSB: mild-moderate NB(TSB range from 220.6μmol/L to 342.0μmol/L),severe NB(TSB higher than 342.0μmol/L).180 term neonates with normal TSB was randomly selected from neonatal ward as control group.All neonates was tested by auditory brainstem response(ABR)and otoacoustic emission(OAE)before discharging.Those infants who with abnormal results was informed to undergo ABR and OAE test and hearing assessment in 3 months,6 months and 12 months old consecutively.Results: The difference of normal rate between mild-moderate NB and control group is statistically significant(P<0.05).The difference of normal rate between severe NB and control group is statistically significant(P<0.05).There is no difference between two groups(P>0.05).The average wave V response threshold between two case groups is statistically different(P<0.05).At 3 months old,2 infants’ results suggest auditory neuropathy spectrum disorder,12 infants manifested as sensorineural hearing loss.6 infants’ results turned normal at 6 months old,3 infants’ results turned normal at 12 months old.Conclusion: The incidence of hearing loss of hyperbilirubinemia neonates in NICU is significantly higher than normal neonates.The magnitude of TSB level demonstrates a correlation with the severity of hearing loss,but mild and moderate hyperbilirubinemia can also lead to hearing loss.Hearing loss caused by hyperbilirubinemia is to some extent reversible,but the high bilirubin level may as well affect the prognosis in the long term.Hyperbilirubinemia requiring exchange transfusion indicates hearing loss and bad prognosis.