{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T23:28:49Z","timestamp":1788305329764,"version":"build-2803163510"},"reference-count":26,"publisher":"American Academy of Pediatrics (AAP)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2017,10,1]]},"abstract":"<jats:sec>\n                  <jats:title>BACKGROUND AND OBJECTIVES:<\/jats:title>\n                  <jats:p>Significant hyperbilirubinemia (SHB) may cause chronic auditory toxicity (auditory neuropathy spectrum disorder and\/or sensorineural hearing loss); however, total serum bilirubin (TSB) does not discriminate neonates at risk for auditory toxicity. Our objective was to compare TSB, bilirubin albumin molar ratio (BAMR), and unbound bilirubin (UB) for their association with chronic auditory toxicity in neonates with SHB (TSB \u226520 mg\/dL or TSB that met criteria for exchange transfusion).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS:<\/jats:title>\n                  <jats:p>Infants \u226534 weeks\u2019 gestational age (GA) with SHB during the first 2 postnatal weeks were eligible for a prospective longitudinal study in India. Comprehensive auditory evaluations were performed at 2 to 3 months of age by using auditory brainstem response, tympanometry, and an otoacoustic emission test and at 9 to 12 months of age by using audiometry. The evaluations were performed by an audiologist unaware of the degree of jaundice.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS:<\/jats:title>\n                  <jats:p>A total of 93 out of 100 infants (mean GA of 37.4 weeks; 55 boys, 38 girls) who were enrolled with SHB were evaluated for auditory toxicity. Of those, 12 infants (13%) had auditory toxicity. On regression analysis controlling for covariates, peak UB (but not peak TSB or peak BAMR), was associated with auditory toxicity (odds ratio 2.41; 95% confidence interval: 1.43\u20134.07; P = .001). There was significant difference in the area under the receiver operating characteristic curves between UB (0.866), TSB (0.775), and BAMR (0.724) for auditory toxicity (P = .03) after controlling for covariates.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS:<\/jats:title>\n                  <jats:p>Unconjugated hyperbilirubinemia indexed by UB (but not TSB or BAMR) is associated with chronic auditory toxicity in infants \u226534 weeks\u2019 GA with SHB.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1542\/peds.2016-4009","type":"journal-article","created":{"date-parts":[[2017,9,27]],"date-time":"2017-09-27T09:10:19Z","timestamp":1506503419000},"source":"Crossref","is-referenced-by-count":35,"title":["Chronic Auditory Toxicity in Late Preterm and Term Infants With Significant Hyperbilirubinemia"],"prefix":"10.1542","volume":"140","author":[{"given":"Sanjiv B.","family":"Amin","sequence":"first","affiliation":[{"name":"Departments of Pediatrics,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satish","family":"Saluja","sequence":"additional","affiliation":[{"name":"Departments of Pediatrics and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arvind","family":"Saili","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Kalawati Saran Children\u2019s Hospital, Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Orlando","sequence":"additional","affiliation":[{"name":"Otolaryngology, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongyue","family":"Wang","sequence":"additional","affiliation":[{"name":"Biostatistics, University of Rochester, Rochester, New York;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nirupama","family":"Laroia","sequence":"additional","affiliation":[{"name":"Departments of Pediatrics,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Asha","family":"Agarwal","sequence":"additional","affiliation":[{"name":"Audiology, Sir Ganga Ram Hospital, Delhi, India; and"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2017,10,1]]},"reference":[{"issue":"2","key":"2021121014420997000_B1","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1136\/adc.2003.039974","article-title":"Rehospitalisation after birth hospitalisation: patterns among infants of all gestations.","volume":"90","author":"Escobar","year":"2005","journal-title":"Arch Dis Child"},{"issue":"4","key":"2021121014420997000_B2","article-title":"Readmission for neonatal jaundice in California, 1991-2000: trends and implications [published correction appears in Pediatrics. 2008;122(3)690].","volume":"121","author":"Burgos","year":"2008","journal-title":"Pediatrics"},{"issue":"5","key":"2021121014420997000_B3","doi-asserted-by":"crossref","first-page":"F342","DOI":"10.1136\/adc.2006.105361","article-title":"Prospective surveillance study of severe hyperbilirubinaemia in the newborn in the UK and Ireland.","volume":"92","author":"Manning","year":"2007","journal-title":"Arch Dis Child Fetal Neonatal Ed"},{"issue":"6","key":"2021121014420997000_B4","doi-asserted-by":"crossref","first-page":"587","DOI":"10.1503\/cmaj.060328","article-title":"Incidence and causes of severe neonatal hyperbilirubinemia in Canada.","volume":"175","author":"Sgro","year":"2006","journal-title":"CMAJ"},{"issue":"1","key":"2021121014420997000_B5","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1542\/peds.114.1.297","article-title":"Management of hyperbilirubinemia in the newborn infant 35 or more weeks of gestation.","volume":"114","author":"American Academy of Pediatrics Subcommittee on Hyperbilirubinemia","year":"2004","journal-title":"Pediatrics"},{"issue":"1","key":"2021121014420997000_B6","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1542\/peds.114.1.263","article-title":"Hyperbilirubinemia and kernicterus: 50 years later.","volume":"114","author":"Ip","year":"2004","journal-title":"Pediatrics"},{"issue":"2","key":"2021121014420997000_B7","doi-asserted-by":"crossref","first-page":"474","DOI":"10.1542\/peds.2005-0395","article-title":"Toward understanding kernicterus: a challenge to improve the management of jaundiced newborns.","volume":"117","author":"Wennberg","year":"2006","journal-title":"Pediatrics"},{"issue":"3","key":"2021121014420997000_B8","doi-asserted-by":"crossref","first-page":"352","DOI":"10.1177\/000348947908800310","article-title":"Cochlear and brain stem responses in hearing loss following neonatal hyperbilirubinemia.","volume":"88","author":"Chisin","year":"1979","journal-title":"Ann Otol Rhinol Laryngol"},{"issue":"4","key":"2021121014420997000_B9","doi-asserted-by":"crossref","first-page":"395","DOI":"10.1001\/archpedi.1969.02100030397002","article-title":"CNS abnormalities after neonatal hemolytic disease or hyperbilirubinemia. 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