Download PDF
J Am Acad Audiol 2018; 29(08): 748-763
DOI: 10.3766/jaaa.17043
Articles
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Transient Otoacoustic Emissions and Auditory Brainstem Responses in Low-Risk Cohort of Newborn and One-Month-Old Infants: Assessment of Infant Auditory System Physiology in the Prenatal Alcohol in SIDS and Stillbirth Network Safe Passage Study

Yvonne S. Sininger
*   Department of Head & Neck Surgery, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA
†   C&Y Consultants, LLC, Santa Fe, NM
,
Carmen G. Condon
‡   Division of Developmental Neuroscience, New York State Psychiatric Institute, New York, NY
,
Howard J. Hoffman
§   Epidemiology and Statistics Program, National Institute on Deafness and Other Communication Disorders (NIDCD), National Institutes of Health (NIH), Bethesda, MD
,
Amy J. Elliott
¶   Center for Health Outcomes and Population Research, Sanford Research, Sioux Falls, SD
‖   Department of Pediatrics, Sanford School of Medicine, University of South Dakota, Sioux Falls, SD
,
Hein J. Odendaal
**   Department of Obstetrics and Gynaecology, Faculty of Medicine and Health Science, Stellenbosch University, Cape Town, South Africa
,
Larry L. Burd
††   Department of Pediatrics, University of North Dakota Fetal Alcohol Syndrome Center, Grand Forks, ND
‡‡   University of North Dakota School of Medicine and Health Sciences, Grand Forks, ND
§§   University of North Dakota School of Medicine, Grand Forks, ND
,
Michael M. Myers
†   C&Y Consultants, LLC, Santa Fe, NM
¶¶   Department of Psychiatry, Columbia University Medical Center, New York, NY
‖‖   Department of Pediatrics, Columbia University Medical Center, New York, NY
,
William P. Fifer
†   C&Y Consultants, LLC, Santa Fe, NM
¶¶   Department of Psychiatry, Columbia University Medical Center, New York, NY
‖‖   Department of Pediatrics, Columbia University Medical Center, New York, NY
› Author Affiliations
Further Information

Publication History

Publication Date:
29 May 2020 (online)

Also available at
   Permissions and Reprints

Abstract

Background:

The Prenatal Alcohol and Sudden Infant Death Syndrome and Stillbirth Network, known as the “Safe Passage Study,” enrolled approximately 12,000 pregnant women from the United States and South Africa and followed the development of their babies through pregnancy and the infant’s first year of life to investigate the role of prenatal alcohol exposure in the risk for sudden infant death syndrome (SIDS) and adverse pregnancy outcomes, such as stillbirth and fetal alcohol spectrum disorders.

Purpose:

Auditory system tests were included in the physiologic test battery used to study the effects of prenatal alcohol exposure on neurophysiology and neurodevelopment, as well as potential causal relationships between neurodevelopmental disorders and SIDS and/or stillbirth. The purpose of this manuscript is to describe normative results when using the auditory test battery applied.

Research Design:

The test battery included the auditory brainstem response (ABR) and transient-evoked otoacoustic emissions (TEOAEs). Data were collected on individual ears of newborns and 1-month-old infants.

Study Sample:

From a cohort of 6,070 with auditory system exams, a normative subsample of 325 infants were selected who were not exposed prenatally to alcohol, cigarette smoke, or drugs nor were they preterm or low birthweight. The subsample is small relative to the overall study because of strict criteria for no exposure to substances known to be associated with SIDS or stillbirth and the exclusion of preterm and low birthweight infants. Expectant mothers were recruited from general maternity at two comprehensive clinical sites, in the northern plains in the United States and in Cape Town, South Africa. These populations were selected for study because both were known to be at high-risk for SIDS and stillbirth.

Data Collection and Analysis:

ABR and TEOAE recordings were stored electronically. Peak latency and amplitude analysis of ABRs were determined by study personnel, and results were evaluated for differences by age, sex, test site, race, and ear (left versus right).

Results:

TEOAE findings were consistent with existing literature including the increase in signal-to-noise (SNR) over the first month of life. The SNR increase is due to an increase in amplitude of the emission. TEOAE amplitude asymmetry favoring the right ear was found, whereas SNR asymmetry was not, perhaps because of the small sample size. A nonsignificant trend toward larger responses in female babies was found; a result that is generally statistically significant in studies with larger samples. Latencies were found to be shorter in ABRs elicited in the right ear with amplitudes that were slightly bigger on average. An expected decrease in wave V latency was observed from birth to 1-month of age, but the finding was of borderline significance (p = 0.058).

Conclusions:

One month is a short time to judge development of the auditory system; however, the ABR and TEOAE findings were consistent with current literature. We conclude that the auditory system data acquired for the Safe Passage Study, as reflected in the data obtained from this cohort of “unexposed” infants, is consistent with published reports of these auditory system measures in the general population.

Key Words

auditory brainstem response - sudden infant death syndrome - transient-evoked otoacoustic emissions
 

  • REFERENCES

  • Abdala C, Oba SI, Ramanathan R. 2008; Changes in the DP-gram during the preterm and early postnatal period. Ear Hear 29 (04) 512-523
    CrossrefPubMedGoogle Scholar
  • Aidan D, Lestang P, Avan P, Bonfils P. 1997; Characteristics of transient-evoked otoacoustic emissions (TEOES) in neonates. Acta Otolaryngol 117 (01) 25-30
    PubMedGoogle Scholar
  • Ari-Even Roth D, Hildesheimer M, Roziner I, Henkin Y. 2016; Evidence for a right-ear advantage in newborn hearing screening results. Trends Hear 20: 20
    Google Scholar
  • Backus BC. 2007; Bias due to noise in otoacoustic emission measurements. J Acoust Soc Am 121 (03) 1588-1603
    CrossrefPubMedGoogle Scholar
  • Berninger E. 2007; Characteristics of normal newborn transient-evoked otoacoustic emissions: ear asymmetries and sex effects. Int J Audiol 46 (11) 661-669
    CrossrefPubMedGoogle Scholar
  • Boone RT, Bower CM, Martin PF. 2005; Failed newborn hearing screens as presentation for otitis media with effusion in the newborn population. Int J Pediatr Otorhinolaryngol 69 (03) 393-397
    CrossrefPubMedGoogle Scholar
  • Church MW. 1987; Chronic in utero alcohol exposure affects auditory function in rats and in humans. Alcohol 4 (04) 231-239
    CrossrefPubMedGoogle Scholar
  • Church MW, Holloway JA. 1984; Effects of prenatal ethanol exposure on the postnatal development of the brainstem auditory evoked potential in the rat. Alcohol Clin Exp Res 8 (03) 258-265
    CrossrefGoogle Scholar
  • Cone-Wesson B. 2005; Prenatal alcohol and cocaine exposure: influences on cognition, speech, language, and hearing. J Commun Disord 38 (04) 279-302
    CrossrefPubMedGoogle Scholar
  • Curns AT, Holman RC, Shay DK, Cheek JE, Kaufman SF, Singleton RJ, Anderson LJ. 2002; Outpatient and hospital visits associated with otitis media among American Indian and Alaska native children younger than 5 years. Pediatrics 109 (03) E41-E41
    CrossrefPubMedGoogle Scholar
  • Don M, Elberling C. 1994; Evaluating residual background noise in human auditory brain-stem responses. J Acoust Soc Am 96 5 Pt 1 2746-2757
    CrossrefPubMedGoogle Scholar
  • Don M, Ponton CW, Eggermont JJ, Masuda A. 1994; Auditory brainstem response (ABR) peak amplitude variability reflects individual differences in cochlear response times. J Acoust Soc Am 96 (06) 3476-3491
    CrossrefPubMedGoogle Scholar
  • Doyle KJ, Burggraaff B, Fujikawa S, Kim J, MacArthur CJ. 1997; Neonatal hearing screening with otoscopy, auditory brain stem response, and otoacoustic emissions. Otolaryngol Head Neck Surg 116 6 Pt 1 597-603
    CrossrefPubMedGoogle Scholar
  • Dukes KA, Burd L, Elliott AJ, Fifer WP, Folkerth RD, Hankins GD, Hereld D, Hoffman HJ, Myers MM, Odendaal HJ, Signore C, Sullivan LM, Willinger M, Wright C, Kinney HC. PASS Research Network The safe passage study: design, methods, recruitment, and follow-up approach. Paediatr Perinat Epidemiol 28 (05) 455-465
    Google Scholar
  • Eggermont JJ, Salamy A. 1988; Development of ABR parameters in a preterm and a term born population. Ear Hear 9 (05) 283-289
    CrossrefPubMedGoogle Scholar
  • Eldredge L, Salamy A. 1996; Functional auditory development in preterm and full term infants. Early Hum Dev 45 (03) 215-228
    CrossrefPubMedGoogle Scholar
  • Ey JL, Holberg CJ, Aldous MB, Wright AL, Martinez FD, Taussig LM. Group Health Medical Associates. 1995; Passive smoke exposure and otitis media in the first year of life. Pediatrics 95 (05) 670-677
    PubMedGoogle Scholar
  • Headley GM, Campbell DE, Gravel JS. 2000; Effect of neonatal test environment on recording transient-evoked otoacoustic emissions. Pediatrics 105 (06) 1279-1285
    CrossrefPubMedGoogle Scholar
  • Hunter LL, Davey CS, Kohtz A, Daly KA. 2007; Hearing screening and middle ear measures in American Indian infants and toddlers. Int J Pediatr Otorhinolaryngol 71 (09) 1429-1438
    CrossrefPubMedGoogle Scholar
  • Jacobson JT, Jacobson CA. 1994; The effects of noise in transient EOAE newborn hearing screening. Int J Pediatr Otorhinolaryngol 29 (03) 235-248
    CrossrefPubMedGoogle Scholar
  • Kable JA, Coles CD, Lynch ME, Carroll J. 2009; The impact of maternal smoking on fast auditory brainstem responses. Neurotoxicol Teratol 31 (04) 216-224
    CrossrefPubMedGoogle Scholar
  • Keefe DH, Zhao F, Neely ST, Gorga MP, Vohr BR. 2003; Ear-canal acoustic admittance and reflectance effects in human neonates. I. Predictions of otoacoustic emission and auditory brainstem responses. J Acoust Soc Am 113 (01) 389-406
    CrossrefPubMedGoogle Scholar
  • Kei J, McPherson B, Smyth V, Latham S, Loscher J. 1997; Transient evoked otoacoustic emissions in infants: effects of gender, ear asymmetry and activity status. Audiology 36 (02) 61-71
    CrossrefPubMedGoogle Scholar
  • Khalfa S, Morlet T, Micheyl C, Morgon A, Collet L. 1997; Evidence of peripheral hearing asymmetry in humans: clinical implications. Acta Otolaryngol 117 (02) 192-196
    CrossrefPubMedGoogle Scholar
  • Norton SJ, Gorga MP, Widen JE, Vohr BR, Folsom RC, Sininger YS, Cone-Wesson B, Fletcher KA. 2000; Identification of neonatal hearing impairment: transient evoked otoacoustic emissions during the perinatal period. Ear Hear 21 (05) 425-442
    CrossrefPubMedGoogle Scholar
  • Olusanya BO. 2010; Ambient noise levels and infant hearing screening programs in developing countries: an observational report. Int J Audiol 49 (08) 535-541
    CrossrefPubMedGoogle Scholar
  • Prieve BA, Hancur-Bucci CA, Preston JL. 2009; Changes in transient-evoked otoacoustic emissions in the first month of life. Ear Hear 30 (03) 330-339
    CrossrefPubMedGoogle Scholar
  • Rubens DD, Vohr BR, Tucker R, O’Neil CA, Chung W. 2008; Newborn oto-acoustic emission hearing screening tests: preliminary evidence for a marker of susceptibility to SIDS. Early Hum Dev 84 (04) 225-229
    CrossrefPubMedGoogle Scholar
  • Saitoh Y, Sakoda T, Hazama M, Funakoshi H, Ikeda H, Shibano A, Yajin S, Yoda S, Dake Y, Enomoto T, Kitano H. 2006; Transient evoked otoacoustic emissions in newborn infants: effects of ear asymmetry, gender, and age. J Otolaryngol 35 (02) 133-138
    CrossrefPubMedGoogle Scholar
  • Salamy A. 1984; Maturation of the auditory brainstem response from birth through early childhood. J Clin Neurophysiol 1 (03) 293-329
    CrossrefPubMedGoogle Scholar
  • Sininger Y, Cone B. 2008; Comment on “Ear Asymmetries in middle-ear, cochlear, and brainstem responses in human infants” [J. Acoust. Soc. Am. 123, 1504–1512]. J Acoust Soc Am 124 (03) 1401-1403
    CrossrefPubMedGoogle Scholar
  • Sininger YS, Cone-Wesson B. 2004; Asymmetric cochlear processing mimics hemispheric specialization. Science 305 5690 1581
    CrossrefPubMedGoogle Scholar
  • Sininger YS, Cone-Wesson B. 2006; Lateral asymmetry in the ABR of neonates: evidence and mechanisms. Hear Res 212 1-2 203-211
    CrossrefPubMedGoogle Scholar
  • Sininger YS, Cone-Wesson B, Abdala C. 1998; Gender distinctions and lateral asymmetry in the low-level auditory brainstem response of the human neonate. Hear Res 126 1–2 58-66
    CrossrefPubMedGoogle Scholar
  • Starr A, Sininger Y, Nguyen T, Michalewski HJ, Oba S, Abdala C. 2001; Cochlear receptor (microphonic and summating potentials, otoacoustic emissions) and auditory pathway (auditory brain stem potentials) activity in auditory neuropathy. Ear Hear 22 (02) 91-99
    CrossrefPubMedGoogle Scholar
  • Thornton ARD, Kimm L, Kennedy CR, Cafarelli-Dees D. 1993; External- and middle-ear factors affecting evoked otoacoustic emissions in neonates. Br J Audiol 27 (05) 319-327
    CrossrefPubMedGoogle Scholar
  • Thornton ARD, Marotta N, Kennedy CR. 2003; The order of testing effect in otoacoustic emissions and its consequences for sex and ear differences in neonates. Hear Res 184 1–2 123-130
    CrossrefPubMedGoogle Scholar
  • Willinger M, James LS, Catz C. 1991; Defining the sudden infant death syndrome (SIDS): deliberations of an expert panel convened by the National Institute of Child Health and Human Development. Pediatr Pathol 11 (05) 677-684
    CrossrefPubMedGoogle Scholar