No abstract

UB is a more sensitive predictor than either serum bilirubin or B:A MR of abnormal ABR maturation, and hence transient bilirubin encephalopathy in premature newborns with hyperbilirubinemia.

Early ages of hearing loss identification, hearing aid fitting, and enrollment in early intervention can be achieved for infants from NICUs and WBNs and for infants at risk and not at risk for hearing loss in a large multi-center universal newborn hearing screening program.

Objective-To determine if cord ferritin (CF) concentration, an index of in utero iron status, is associated with auditory neural maturation in premature infants.Study design-A prospective cohort study was performed to compare auditory neural maturation between infants with latent iron deficiency (CF 11-75 ng/ml) and infants with normal iron status (CF > 75 ng/ml) at birth. Our inclusion criteria were 27-33 weeks gestational age infants admitted to the Neonatal Intensive Care Unit between July, 2007 and November, 2008 within 12 hours after birth and had cord blood collected. Infants with TORCH infections, chromosomal disorders, craniofacial anomalies, culture proven sepsis, and/or unstable conditions were excluded. CF concentrations were measured using a chemiluminescence immuno-assay method. Bilateral monaural auditory brainstem evoked responses (ABR) were performed using 80 dB nHL click stimuli at a repetition rate of 29.9/sec within 48 hours after birth.Results-Of 80 infants studied, 35 infants had latent iron deficiency. After controlling for confounders, infants with latent iron deficiency had significantly prolonged absolute wave latencies I, III, and V and decreased frequency of mature ABR waveform compared with infants with normal iron status. Conclusion-Premature infants with in utero latent iron deficiency have abnormal auditory neural maturation compared with infants with normal in utero iron status. KeywordsAuditory brainstem evoked response; latent iron deficiency; cord ferritin; brain development Iron is crucial for fetal brain development and substantial iron accretion occurs during the last trimester of pregnancy.(1-5) Although there is active transport of iron across the placenta, several clinical conditions are known to negatively affect fetal iron status including severe Corresponding Author: Sanjiv B Amin, MD, MS, Department of Pediatrics, PO Box 651, 601 Elmwood Avenue, Rochester, NY -14642, Tel: 585-275-2972, Fax: 585-461-3614, Sanjiv_Amin@urmc.rochester.edu. Edited by AJ and WFB Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. NIH Public Access METHODSA prospective cohort study comparing auditory neural maturation of premature infants with latent iron deficiency (CF 11-75 ng/ml) with premature infants with normal iron status (CF > 75 ng/ml) was conducted. We chose a cord ferrtin concentration of 75 ng/ml as a cut off level to define latent iron deficiency because this cut-off level has been used by previous studies and was shown to be associated with neurodevelopment outcomes in term and premature infants.(15,17) Parental consent was obta...

ArticlesBackground: Little is known about anemia and iron status in US newborns because screening for anemia is typically not undertaken until 1 y of age. This study was undertaken to characterize and identify determinants of iron status in newborns born to pregnant adolescents. Methods: Pregnant adolescents (≤ 18 y, n = 193) were followed from ≥ 12 wk gestation until delivery. Hemoglobin, ferritin, soluble transferrin receptor, serum iron, hepcidin, erythropoietin (EPO), IL-6, and C-reactive protein were assessed in maternal and cord blood. results: At birth, 21% of the neonates were anemic (Hb < 13.0 g/dl) and 25% had low iron stores (ferritin < 76 µg/l). Cord serum ferritin concentrations were not significantly associated with gestational age (GA) at birth across the range of 37-42 wk. Neonates born to mothers with ferritin < 12 µg/l had significantly lower ferritin (P = 0.003) compared to their counterparts. Hepcidin and IL-6 were significantly (P < 0.05) higher in neonates born to mothers with longer durations of active labor. conclusion: Given the importance of the iron stores at birth on maintenance of iron homeostasis over early infancy, additional screening of iron status at birth is warranted among those born to this high risk obstetric population.