Brainstem auditory outcomes and correlation with neurodevelopment after perinatal asphyxia.
We used brainstem auditory-evoked responses and neurodevelopmental assessment to detect abnormalities and correlations between such responses and neurodevelopmental outcomes in 78 children (aged 4-12 years) who survived perinatal asphyxia. Twenty children had brainstem auditory-evoked response abnormalities, including increased threshold, reduced wave V amplitude, decreased V/I amplitude ratio, and prolonged I-V interval. Thirty-seven exhibited neurodevelopmental deficits, including cerebral palsy and developmental delay. The remaining 41 exhibited no deficits. Brainstem auditory-evoked response abnormalities were evident in 15 of 37 (40.5%) children with neurodevelopmental deficits, but in only 5 of 41 (12.2%) with no deficits, which differed significantly (chi(2) = 8.2, P < 0.05). The sensitivity, specificity, positive predictive value, and false-negative rate of brainstem auditory-evoked responses to reflect neurodevelopmental outcomes were 40.5%, 87.8%, 75.0%, and 59.5%, respectively. These findings suggest that in children who survive perinatal asphyxia, brainstem auditory impairment occurs more frequently in those with versus those without neurodevelopmental deficits. Brainstem auditory-evoked responses display a moderate correlation with clinically determined neurodevelopmental outcomes. Despite limitations, brainstem auditory-evoked response is valuable for assessing auditory and neurodevelopmental outcomes after perinatal asphyxia.
Jiang
Ze D
ZD
Department of Pediatrics, Children's Hospital, Fudan University, Shanghai, China. zedong.jiang@paediatrics.ox.ac.uk
Liu
Xian Y
XY
Shi
Bin P
BP
Lin
Li
L
Bu
Cui F
CF
Wilkinson
Andrew R
AR
D001238:Asphyxia Neonatorum / Q000150:complications / Q000503:physiopathology*; D001933:Brain Stem / Q000503:physiopathology*; D002493:Central Nervous System Diseases / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology*; D002547:Cerebral Palsy / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology; D002648:Child; D002675:Child, Preschool; D002658:Developmental Disabilities / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology*; D016057:Evoked Potentials, Auditory, Brain Stem; D005260:Female; D005500:Follow-Up Studies; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index