127 - Low neonatal reticulocyte hemoglobin content, an early indicator of iron deficiency is associated with abnormal auditory neural myelination.

Saturday, April 29, 2023

3:30 PM – 6:00 PM ET

Poster Number: 127
Publication Number: 127.239

Dimitrios Rallis, UNIVERSITY OF IOANNINA, Ioannina, Ioannina, Greece; Evgeniya Babacheva, Papageorgiou, Thessaloniki, Thessaloniki, Greece; Vasileios NIKOLAIDIS, AUTH, THESSALONIKI, Thessaloniki, Greece; Anastasia Kypriotou, Γ. Ν. Παπαγεωργίου, Θεσσαλονίκη, Thessaloniki, Greece; helen christou, Brigham and Women's Hospital, Boston, MA, United States; Georgios Mitsiakos, 2nd Neonatal Department and NICU, Aristotle University of Thessaloniki, Thessaloniki, Thessaloniki, Greece; Maria Lithoxopoulou, Aristotle University of Thessaloniki, Thessaloniki, Thessaloniki, Greece; Christos Tsakalidis, 2nd Neonatal Intensive Care Unit, Aristotle University Thessaloniki, Thessaloniki, Thessaloniki, Greece; Vasiliki Soubasi-Griva, Aistotle University of Thessaloniki, School of Medicine,, Kalamaria, Thessaloniki, Greece

Presenting Author(s)

Dimitrios Rallis, PhD (he/him/his)

Assistant Professor in Neonatology
UNIVERSITY OF IOANNINA
Ioannina, Ioannina, Greece

Background: Overt perinatal iron deficiency has been associated with abnormal neurodevelopment, including auditory dysfunction. However, the relationship between auditory neural maturation and the early marker of iron deficiency, mean reticulocyte hemoglobin content (MCHr), has not been well studied.

Objective: To examine the association of neonatal iron status as assessed by MCHr, ferritin, and erythrocytic indices, with brainstem auditory evoked response (BAER) latencies, in a cohort of infants at risk of iron deficiency, including infants of diabetic mothers (IDMs) and non-IDMs.

Design/Methods:

We conducted a prospective study in the neonatal unit of a University Hospital between 2018-2022, enrolling 36 IDMs and 26 non-IDMs. Erythrocyte indices were analyzed within the first 12 hours after birth. BAER interpeak latencies were recorded with a Bio-logic Navigator diagnostic system (Bio-Logic Systems Corporation, Mundelein, IL, US) between 4-6 months of age. Bilateral monaural tests were performed using 55- and 75-dB normal hearing level broadband click stimuli, at a repetition rate of 69.9/sec. The data were analyzed by an audiologist without knowledge of the neonatal history or laboratory data. Data from each ear were separately analyzed. Latencies III, and V, and the interpeak latency V-III were measured.

Erythrocytic indices and BAER latencies were compared between IDMs and non-IDMs. We examined the association of the neonatal MCHr with the interpeak latencies V-III, after adjusting for IDM, sex, and small for gestational age status with multivariate linear regression analysis.

Results:

There were no significant differences in maternal or neonatal characteristic between IDMs and non-IDMs; however, IDMs had a significantly lower MCHr compared to non-IDMs (31.8±3.5 compared to 33.9±2.5 pg, p=0.034) (Table 1). BAER latency III at 55 dB was significantly prolonged in IDMs compared to non-IDMs (4.13±0.33 compared to 3.94±0.37 msec, p=0.008).

There was a significant inverse association between neonatal MCHr with interpeak latency V-III at 55 dB [coefficient 0.26, 95% confidence interval (CI) 0.04-0.45, p=0.020)] and 75 dB (coefficient 0.14, 95% CI 0.07-0.93, p=0.049), after adjusting for maternal diabetes, sex, and small for gestational age (Table 2).

Conclusion(s):

Lower levels of neonatal MCHr, irrespective of maternal diabetes status, are associated with prolonged BAER interpeak latencies, indicating delayed auditory neural myelination. Our findings support that meticulous evaluation of iron status is needed during neonatal period to avoid the potential long-term effects of iron deficiency in neurodevelopment.