Brainstem evoked response auditory in healthy term neonates with hyperbilirubinemia

Isman Jafar (Department of Child Health, University of Indonesia Medical School/Dr. Cipto Mangunkusumo Hospital, Jakarta)
Irawan Mangunatmadja (Department of Child Health, University of Indonesia Medical School/Dr. Cipto Mangunkusumo Hospital, Jakarta)
Rinawati Rohsiswatmo (Department of Child Health, University of Indonesia Medical School/Dr. Cipto Mangunkusumo Hospital, Jakarta)
Sudjatmiko Sudjatmiko (Department of Child Health, University of Indonesia Medical School/Dr. Cipto Mangunkusumo Hospital, Jakarta)
Ronny Suwento (Department of Ear, Nose, Throat, Head and Neck, University of Indonesia Medical School/Dr. Cipto Mangunkusumo Hospital, Jakarta)
Safarina G. Malik (Institute of Eijkman for Molecular Biology, University of Indonesia, Jakarta)

Paediatrica Indonesiana
Vol 50 No 3 (2010): May 2010

Background Bilirubin in healthy term neonates, especially free bilirubin (Bf), could enter brain cell and cause damage perceived by brainstem evoked response auditory (BERA). Studies identify that Bf is more associated to abnonnal BERA than total bilirubin is. Currently, phototherapy is perfonned in neonates with total bilirubin > 15 mg/dL. However, in developing countries where observation could not be done optimally, neonates \\lith totalbilirubin> 12 mg/dL will be subject for phototherapy.Objectives To determine the association between total bilirubin > 12 mg/dL and BERA abnonnalities in healthy tenn neonates, and the value of total bilirubin and free bilirubin that initiate abnonnal BERA.Methods This cross sectional study was carried out between March 31􀁅August 8, 2008, in healthy term neonates at rooming􀁅in ward, Department of Obstetric & Gy necology, Cipto Mangunkusumo Hospital (CMH). All eligible subjects were examined for Bf and BERA using standard methods. Results The prevalence of abnormal BERA was 15.4%. There was no significant relation between hy perbilirubinemia (> 12 mg/ dL) and abnonnal BERA in healthy tenn neonates. Lowest total bilirubin and Bf level related to abnonnal BERA were 12.4 mg/dL (mean 12.8 mg/dL) and O.oS)Lg/dL (mean l.3)Lg/dL), respectively. All BERA abnonnalities were unilateral.Conclusions There is no association between abnormal BERA and hyperbilirubinemia (total bilirubin> 12 mg/dL) in jaundiced infants who undergo phototherapy.