Effect of Maternal Age and Anaemia on Auditory Brainstem Response of Preterm Infants in a Tertiary Care Hospital of Kolkata, West Bengal: A Cross-sectional Study

Abstract

Introduction: Adolescent pregnancy and maternal anaemia have a detrimental effect on infant growth and development. They are associated with greater risk of premature births and Low Birth Weight (LBW). Wave Interpeak Latencies (IPLs) of infant Auditory Brainstem Response (ABR) indicate the degree of maturation of brainstem auditory pathways among preterm infants. Previous studies indicated that preterm infants show prolonged wave Interpeak Latencies (IPLs). Whether maternal parameters like age and haemoglobin level contributes to the changes in infant ABR is debated. Aim: To study the effect of maternal age and anaemic status on Brainstem Evoked Response Audiometry (BERA) changes among preterm infants. Materials and Methods: An observational, descriptive study of cross-sectional design was undertaken in the Neurophysiology laboratory of Department of Physiology, RG Kar Medical College and Hospital, Kolkata from December 2019 to December 2022. Total of 119 mother-preterm infant dyads were included. Click BERA was performed on the babies aged between 3 months to 1 year. Absolute and IPLs of wave I,III and V were obtained. Mothers were assigned anaemic status {Haempglobin (Hb) level<9gm/dL} based on the information in their antenatal card. Student’s t test, Fisher’s exact test, one way ANOVA test were used for data analysis. A p-value less than 0.05 was considered significant. Results: Out of 76 adolescent mothers (age between 10 to <18 years), 43 (56.6%) were anaemic. Out of 43 adult mothers (with age ≥18 years), 33 (76.7%) were anaemic. Mothers were divided into four groups, namely adolescent anaemic (n=43) and adolescent non anaemic (n=33), adult anaemic (n=33) and adult non anaemic (n=10). Distribution of data with respect to education years, social class and occupation among four mothers’ group was comparable [p-value>0.05]. Preterm infants born to both anaemic adult [Hedges g=2.51] and anaemic adolescent mothers [Hedges g=1.06] showed dyssynchronous shortening of wave latencies compared to non anaemic counterparts (p-value<0.05). Magnitude of difference with respect to infant ABR for non anaemic adolescent mothers vs non anaemic adult counterparts was large [Hedge s g=1.05] with p-value<0.05. While maternal anaemia showed either shortening or prolongation of IPLs, adolescent maternal age was related with prolongation of the wave I-V. Effect size of maternal anaemia on infant ABR was more than for adolescent maternal age. Conclusion: Maternal anaemia may exaggerate abnormal maturation of the brain stem pathways in preterm infants irrespective of maternal age.