Sensitivity and specificity of the neonatal brain-stem auditory evoked potential for hearing and language deficits in survivors of extracorporeal membrane oxygenation

S. Desai, P. R. Kollros, L. J. Graziani, Leopold Streletz, M. Goodman, C. Stanley, J. Cullen, S. Baumgart

Research output: Contribution to journalArticle

21 Citations (Scopus)

Abstract

Objective: We determined the sensitivity and specificity of neonatal brain-stem auditory evoked potentials (BAEP) as markers for subsequent hearing impairment and for developmental problems found later in infancy and childhood. Methods: BAEP studies were performed before discharge in infants treated with extracorporeal membrane oxygenation (ECMO), and two specific abnormalities were analyzed: elevated threshold and delayed central auditory conduction. Behavioral audiometry was repeated during periodic follow-up until reliable responses were obtained for all frequencies, and standardized developmental testing was also conducted. The sensitivity and specificity of an elevated threshold on the neonatal BAEP for detecting subsequent hearing loss, and the relationship of any neonatal BAEP abnormality to language or developmental disorders in infancy, were calculated. Results: Test results for 46 ECMO-treated infants (57.5%) were normal, and those for 34 infants (42.5%) were abnormal, with either elevated wave V threshold, prolonged wave I-V interval, or both on neonatal BAEP recordings. Most significantly, 7 (58%) of the 12 children with subsequent sensorineural hearing loss had left the hospital after showing normal results on threshold tests. There was no significant difference in the frequency of hearing loss between subjects with abnormal (5/21, or 24%) and those with normal BAEP thresholds (7/59, or 12%; Fisher Exact Test, p = 0.28). Therefore the sensitivity of neonatal BAEP testing for predicting subsequent hearing loss was only 42%. Neonatal BAEP specificity for excluding subsequent hearing loss was 76%. In contrast, on language development testing, 19 children demonstrated receptive language delay. Of these children, 12 (63%) had abnormal neonatal BAEP recordings and 7 (37%) had a normal BAEP threshold, normal central auditory conduction test results, or both (p = 0.04). Conclusions: Neonatal BAEP threshold recordings were of limited value for predicting subsequent hearing loss common in ECMO- treated survivors. However, an abnormal neonatal BAEP significantly increased the probability of finding a receptive language delay during early childhood, even in those with subsequently normal audiometry findings. Because neonatal ECMO is associated with a high risk of hearing and receptive language disorders, parents should be counseled that audiologic and developmental follow-up evaluations in surviving children are essential regardless of the results of neonatal BAEP testing.

Original languageEnglish
Pages (from-to)233-239
Number of pages7
JournalJournal of Pediatrics
Volume131
Issue number2
DOIs
Publication statusPublished - 1997
Externally publishedYes

Fingerprint

Extracorporeal Membrane Oxygenation
Brain Stem Auditory Evoked Potentials
Hearing
Language
Sensitivity and Specificity
Hearing Loss
Language Development Disorders
Audiometry
Language Disorders
Language Development
Sensorineural Hearing Loss
Survivors

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Sensitivity and specificity of the neonatal brain-stem auditory evoked potential for hearing and language deficits in survivors of extracorporeal membrane oxygenation. / Desai, S.; Kollros, P. R.; Graziani, L. J.; Streletz, Leopold; Goodman, M.; Stanley, C.; Cullen, J.; Baumgart, S.

In: Journal of Pediatrics, Vol. 131, No. 2, 1997, p. 233-239.

Research output: Contribution to journalArticle

Desai, S. ; Kollros, P. R. ; Graziani, L. J. ; Streletz, Leopold ; Goodman, M. ; Stanley, C. ; Cullen, J. ; Baumgart, S. / Sensitivity and specificity of the neonatal brain-stem auditory evoked potential for hearing and language deficits in survivors of extracorporeal membrane oxygenation. In: Journal of Pediatrics. 1997 ; Vol. 131, No. 2. pp. 233-239.
@article{3598c701df4a4c77aa2a2a7ab4bf9074,
title = "Sensitivity and specificity of the neonatal brain-stem auditory evoked potential for hearing and language deficits in survivors of extracorporeal membrane oxygenation",
abstract = "Objective: We determined the sensitivity and specificity of neonatal brain-stem auditory evoked potentials (BAEP) as markers for subsequent hearing impairment and for developmental problems found later in infancy and childhood. Methods: BAEP studies were performed before discharge in infants treated with extracorporeal membrane oxygenation (ECMO), and two specific abnormalities were analyzed: elevated threshold and delayed central auditory conduction. Behavioral audiometry was repeated during periodic follow-up until reliable responses were obtained for all frequencies, and standardized developmental testing was also conducted. The sensitivity and specificity of an elevated threshold on the neonatal BAEP for detecting subsequent hearing loss, and the relationship of any neonatal BAEP abnormality to language or developmental disorders in infancy, were calculated. Results: Test results for 46 ECMO-treated infants (57.5{\%}) were normal, and those for 34 infants (42.5{\%}) were abnormal, with either elevated wave V threshold, prolonged wave I-V interval, or both on neonatal BAEP recordings. Most significantly, 7 (58{\%}) of the 12 children with subsequent sensorineural hearing loss had left the hospital after showing normal results on threshold tests. There was no significant difference in the frequency of hearing loss between subjects with abnormal (5/21, or 24{\%}) and those with normal BAEP thresholds (7/59, or 12{\%}; Fisher Exact Test, p = 0.28). Therefore the sensitivity of neonatal BAEP testing for predicting subsequent hearing loss was only 42{\%}. Neonatal BAEP specificity for excluding subsequent hearing loss was 76{\%}. In contrast, on language development testing, 19 children demonstrated receptive language delay. Of these children, 12 (63{\%}) had abnormal neonatal BAEP recordings and 7 (37{\%}) had a normal BAEP threshold, normal central auditory conduction test results, or both (p = 0.04). Conclusions: Neonatal BAEP threshold recordings were of limited value for predicting subsequent hearing loss common in ECMO- treated survivors. However, an abnormal neonatal BAEP significantly increased the probability of finding a receptive language delay during early childhood, even in those with subsequently normal audiometry findings. Because neonatal ECMO is associated with a high risk of hearing and receptive language disorders, parents should be counseled that audiologic and developmental follow-up evaluations in surviving children are essential regardless of the results of neonatal BAEP testing.",
author = "S. Desai and Kollros, {P. R.} and Graziani, {L. J.} and Leopold Streletz and M. Goodman and C. Stanley and J. Cullen and S. Baumgart",
year = "1997",
doi = "10.1016/S0022-3476(97)70159-8",
language = "English",
volume = "131",
pages = "233--239",
journal = "Journal of Pediatrics",
issn = "0022-3476",
publisher = "Mosby Inc.",
number = "2",

}

TY - JOUR

T1 - Sensitivity and specificity of the neonatal brain-stem auditory evoked potential for hearing and language deficits in survivors of extracorporeal membrane oxygenation

AU - Desai, S.

AU - Kollros, P. R.

AU - Graziani, L. J.

AU - Streletz, Leopold

AU - Goodman, M.

AU - Stanley, C.

AU - Cullen, J.

AU - Baumgart, S.

PY - 1997

Y1 - 1997

N2 - Objective: We determined the sensitivity and specificity of neonatal brain-stem auditory evoked potentials (BAEP) as markers for subsequent hearing impairment and for developmental problems found later in infancy and childhood. Methods: BAEP studies were performed before discharge in infants treated with extracorporeal membrane oxygenation (ECMO), and two specific abnormalities were analyzed: elevated threshold and delayed central auditory conduction. Behavioral audiometry was repeated during periodic follow-up until reliable responses were obtained for all frequencies, and standardized developmental testing was also conducted. The sensitivity and specificity of an elevated threshold on the neonatal BAEP for detecting subsequent hearing loss, and the relationship of any neonatal BAEP abnormality to language or developmental disorders in infancy, were calculated. Results: Test results for 46 ECMO-treated infants (57.5%) were normal, and those for 34 infants (42.5%) were abnormal, with either elevated wave V threshold, prolonged wave I-V interval, or both on neonatal BAEP recordings. Most significantly, 7 (58%) of the 12 children with subsequent sensorineural hearing loss had left the hospital after showing normal results on threshold tests. There was no significant difference in the frequency of hearing loss between subjects with abnormal (5/21, or 24%) and those with normal BAEP thresholds (7/59, or 12%; Fisher Exact Test, p = 0.28). Therefore the sensitivity of neonatal BAEP testing for predicting subsequent hearing loss was only 42%. Neonatal BAEP specificity for excluding subsequent hearing loss was 76%. In contrast, on language development testing, 19 children demonstrated receptive language delay. Of these children, 12 (63%) had abnormal neonatal BAEP recordings and 7 (37%) had a normal BAEP threshold, normal central auditory conduction test results, or both (p = 0.04). Conclusions: Neonatal BAEP threshold recordings were of limited value for predicting subsequent hearing loss common in ECMO- treated survivors. However, an abnormal neonatal BAEP significantly increased the probability of finding a receptive language delay during early childhood, even in those with subsequently normal audiometry findings. Because neonatal ECMO is associated with a high risk of hearing and receptive language disorders, parents should be counseled that audiologic and developmental follow-up evaluations in surviving children are essential regardless of the results of neonatal BAEP testing.

AB - Objective: We determined the sensitivity and specificity of neonatal brain-stem auditory evoked potentials (BAEP) as markers for subsequent hearing impairment and for developmental problems found later in infancy and childhood. Methods: BAEP studies were performed before discharge in infants treated with extracorporeal membrane oxygenation (ECMO), and two specific abnormalities were analyzed: elevated threshold and delayed central auditory conduction. Behavioral audiometry was repeated during periodic follow-up until reliable responses were obtained for all frequencies, and standardized developmental testing was also conducted. The sensitivity and specificity of an elevated threshold on the neonatal BAEP for detecting subsequent hearing loss, and the relationship of any neonatal BAEP abnormality to language or developmental disorders in infancy, were calculated. Results: Test results for 46 ECMO-treated infants (57.5%) were normal, and those for 34 infants (42.5%) were abnormal, with either elevated wave V threshold, prolonged wave I-V interval, or both on neonatal BAEP recordings. Most significantly, 7 (58%) of the 12 children with subsequent sensorineural hearing loss had left the hospital after showing normal results on threshold tests. There was no significant difference in the frequency of hearing loss between subjects with abnormal (5/21, or 24%) and those with normal BAEP thresholds (7/59, or 12%; Fisher Exact Test, p = 0.28). Therefore the sensitivity of neonatal BAEP testing for predicting subsequent hearing loss was only 42%. Neonatal BAEP specificity for excluding subsequent hearing loss was 76%. In contrast, on language development testing, 19 children demonstrated receptive language delay. Of these children, 12 (63%) had abnormal neonatal BAEP recordings and 7 (37%) had a normal BAEP threshold, normal central auditory conduction test results, or both (p = 0.04). Conclusions: Neonatal BAEP threshold recordings were of limited value for predicting subsequent hearing loss common in ECMO- treated survivors. However, an abnormal neonatal BAEP significantly increased the probability of finding a receptive language delay during early childhood, even in those with subsequently normal audiometry findings. Because neonatal ECMO is associated with a high risk of hearing and receptive language disorders, parents should be counseled that audiologic and developmental follow-up evaluations in surviving children are essential regardless of the results of neonatal BAEP testing.

UR - http://www.scopus.com/inward/record.url?scp=0030706063&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0030706063&partnerID=8YFLogxK

U2 - 10.1016/S0022-3476(97)70159-8

DO - 10.1016/S0022-3476(97)70159-8

M3 - Article

VL - 131

SP - 233

EP - 239

JO - Journal of Pediatrics

JF - Journal of Pediatrics

SN - 0022-3476

IS - 2

ER -