Hyperbilirubinemia impact on newborn hearing: a literature review

Abstract

SUMMARY The increase in bilirubin levels in newborns can cause toxic effects on the auditory system, which can lead to hearing loss. This review aimed to verify the impact of hyperbilirubinemia in the hearing of newborns, relating audiological findings to serum levels of bilirubin. A literature review was conducted during October 2017, using the terms “hyperbilirubinemia”, “jaundice”, “infant”, “newborn” and “hearing loss”, on databases CAPES journals, MEDLINE and BIREME (SciELO, BBO). 827 studies were identified and 59 were selected for full-text reading, resulting in the selection of seven articles that met the inclusion criteria and were considered relevant to the sample of this study. All the reviewed studies performed brainstem auditory evoked potential as the main test for audiological evaluation. Changes in the audiological findings of neonates with hyperbilirubinemia were observed in all studies. There was no consensus on the serum bilirubin levels that may cause auditory changes; however, the relationship between hearing disorders and blood levels of bilirubin was positive. We identify the need to establish reference values for bilirubin levels considered critical for the occurrence of hearing disorders as well as the audiological follow-up of neonates with hyperbilirubinemia.

Threshold and Correlation of Total Serum Bilirubin with Screening Automated Auditory Brainstem Response Among Newborns with Hyperbilirubinemia in National Hospital Abuja

“…However, one study reported no statistically significant difference between UB and TSB as predictors of hearing loss. 24 In a systematic review, Teixeira et al 25 reported a statistically significant correlation between audiological (ABR) changes and bilirubin levels, although TSB, UCB, or CB was used in the studies reviewed. According to that review, where no such correlation can be found, the reasons were differences in the bilirubin levels defined as critical to the start of treatment as well as the type of bilirubin used in the studies.…”

Congenital Deafness and Recent Advances Towards Restoring Hearing Loss

“…The pathophysiology of hyperbilirubinemia includes an auditory pathway problem with normal peripheral function of the ear such as non-affected hair cells ( Belal, 1975 ; Shaia, Shapiro, & Spencer, 2005 ). Studies have showed increase in ABR (Auditory Brainstem Response) latencies and interpeak intervals in hyperbilirubinemia animal models ( Shapiro & Hecox, 1989 ; Teixeira, Borges, Riesgo, & Sleifer, 2020 ). This phenomenon can be explained by the degenerative appearance of the spiral ganglion, where the neurons demonstrate decreased size and a lack of myelinated axons ( Shaia et al, 2005 ).…”

Magnetic resonance spectroscopy and auditory brain-stem response audiometry as predictors of bilirubin-induced neurologic dysfunction in full-term jaundiced neonates

“…The auditory system is sensitive to the neurotoxicity of bilirubin. In fact, it is believed that the cochlear nuclei of the brainstem are one of the first structures impacted by a high total bilirubin level, followed by the auditory nerve [ 7 ]. This harm may happen in a lack of other classic bilirubin encephalopathy signs and is recognized as auditory neuropathy spectrum disorder (ANSD), which is often characterized by impaired auditory neural function (altered or absent auditory brainstem response audiometry (ABR) waveforms) in the existence of normal cochlear microphonics and/or cochlear otoacoustic emission [ 8 ].…”

“…These auditory implications might vary from slight speech and hearing processing impairments to total deafness, which is perceived by ABR audiometry; hence, an abnormal ABR result signifies the presence of acute bilirubin encephalopathy (ABE) and is considered the most common and the earliest manifestation of ABE [ 7 ].…”