Brainstem auditory evoked response (BAER) measurement in premature infants; effect of bilirubin levels and different nutritional regiments.

Severe hyperbilirubinemia is known to cause sensorineural hearing loss. An incidence of up to 87% for hearing function disorders diagnosed by abnormal BAER results has been reported18. It is reported that BAER parameters can improve after blood transfusion19-21. However in about 50% of children non reversible changes were found22. Most of these results are from studies in full term neonates. It is suggested that preterm infants are at higher risk of developing hearing disorders as a result of hyperbilirubinemia because the auditory system is affected in an earlier stage of maturation18. In this study we will investigate the effect of bilrubin levels on hearing function in preterm infants by BAER testing. We will investigate changes in auditory function by repeating BEAR testing at 46 weeks postmenstrual age.

Higher bilirubin levels (possibly as a results of different nutritional regiments) may alter BAER parameters and cause hearing loss.

BAER measurement will be obtained within the first 3 weeks after birth and will be repeated at 46 weeks postconceptional age.

BAER recording will be conducted at 7 (+/- 2) and 14 (+/- 2) days postnatally and at 46 weeks postconceptional age.



Children will be randomly selected from the following nutritional intervention groups (NIPI-2):

Group A will receive lipids from birth onwards. Group B will receive extra amino acids in combination with lipids from birth onwards. The control group will be fed according to the standard nutrition policy (lipids from day 2 or 3 onwards). Different lipid emulsions will be compared.