Murray A D
Department of Human Development and Family Studies, Kansas State University, Manhattan 66506.
Child Dev. 1988 Dec;59(6):1542-54.
The purpose of this study was to determine the degree to which auditory brainstem evoked responses (ABRs) measured in newborns may predict delayed or impaired development during the first year of life. 93 high- and low-risk infants with normal and abnormal newborn ABRs were evaluated at 3, 6, and 9 months of age. Newborns with abnormal ABRs were further grouped according to diagnoses of sensorineural hearing loss (N = 11) or neuromaturational delay (N = 16). Data collected included measures of mental, motor, neurological, auditory, and speech/language development. After adjusting for risk-group membership, infants with abnormal newborn ABRs were found to differ from those with normal ABRs on summary handicap ratings and on individual measures of functioning. Measures of motor development and communicative development were most strongly associated with abnormalities in the newborn ABR. Developmental outcome for the sensorineural group was the poorest, with the performance of the maturational delay group falling between the sensorineural and normal groups on most measures. The predictive accuracy of the newborn ABR was moderate for detecting sensorineural hearing impairment and low to moderate for detecting deviant neurobehavioral development. We conclude that abnormalities in the newborn ABR may indicate diffuse CNS dysfunction in addition to deficits specific to the auditory system.
本研究的目的是确定在新生儿中测量的听觉脑干诱发电位（ABR）能够预测生命第一年发育延迟或受损的程度。对93例具有正常和异常新生儿ABR的高危和低危婴儿在3、6和9月龄时进行评估。ABR异常的新生儿根据感音神经性听力损失（N = 11）或神经成熟延迟（N = 16）的诊断进一步分组。收集的数据包括智力、运动、神经、听觉和言语/语言发育的测量指标。在对风险组归属进行校正后，发现ABR异常的婴儿与ABR正常的婴儿在综合残疾评定和个体功能测量方面存在差异。运动发育和交流发育的测量指标与新生儿ABR异常关联最为密切。感音神经性组的发育结局最差，在大多数测量指标上，成熟延迟组的表现介于感音神经性组和正常组之间。新生儿ABR在检测感音神经性听力障碍方面的预测准确性中等，在检测异常神经行为发育方面的预测准确性低至中等。我们得出结论，新生儿ABR异常除了表明听觉系统特定缺陷外，还可能提示弥漫性中枢神经系统功能障碍。
