Prediction of hearing impairment by indirect hyperbilirubinemia in neonates

Background: Hearing is a special sense and one of the most important components of communication. The ability to communicate and acquiring skills largely depends on the ability of hearing. Hearing impairment can have a substantial influence on a child's speaking ability, language development and social skills. Early detection and timely initiation of treatment for childhood hearing loss is very crucial as inadequate auditory input during first few years of life irreversibly delays the language skills for communication and reading. This study aimed to predict the frequency of hearing impairment in neonates with indirect hyperbilirubinemia. Methods: This was a cross-sectional study conducted at the Neonatal intensive care unit (NICU) and Special care neonatal unit (SCANU) of Bangladesh Shishu Hospital and Institute, Dhaka, Bangladesh during the period from January 2020 to December 2021. In this study, we included 85 hospitalized neonates with hyperbilirubinemia based on the selection criteria. Results: The mean age of the patients was 5.6 (±1.6) days. Pre-term babies were 63.5% and 36.5% were termed babies. Among all patients, 49.4% and 43.5% of patients had indirect bilirubin levels from 15 to<20 mg/dl & 20 to<25 mg/dl respectively. Among 11 hearing-impaired neonates, 3 (27.2%) had mild to moderate impairment, 6 (54.5%) had moderate to severe impairment and 2 (18.1%) had severe to profound hearing impairment. Sepsis, ototoxic drugs and indirect hyperbilirubinemia were independent predictors of hearing impairment. Conclusions: This study concluded that indirect hyperbilirubinemia of≥15 mg/dl in preterm and≥20 mg/dl in term neonates is an important predictor of hearing impairment in neonates.