Auditory neural myelination is associated with early childhood language development in premature infants

Background: Auditory neural myelination (ANM) as evaluated by auditory brainstem evoked response (ABR)
during the neonatal period has been used as a surrogate outcome for long-termneurodevelopment. The validity
of ANM as a surrogate outcome for long-term neurodevelopment has not been well studied.
Aim: Evaluate the association of ABR I–V interpeak latency (IPL), an index of ANM, at 35 week postmenstrual age
(PMA) with language outcome at 3 years of age.
Design: Prospective study.
Subjects: 24–33 week gestational age (GA) infants were eligible if they did not meet exclusion criteria: craniofacial
malformation, chromosomal disorders, deafness, auditory dys-synchrony, TORCH infection, or non-English
speaking parents. Infants with malignancy, head injury, encephalopathy, meningitis, blindness, or who died or
relocated were also excluded.
Outcomemeasures: ABRs were performed at 35week PMAusing 80 dB nHL and I–V IPL (ms) measured. Auditory
Comprehension (AC) and Expressive Communication (EC) were evaluated by a speech-language pathologist at
3 years of age using Preschool Language Scale.
Results: Eighty infants were studied. The mean GA and birth weight of infants were 29.2 weeks and 1336 g,
respectively. There was association of worse ear I–V IPL and better ear I–V IPL with AC (Coefficient−5.4,
95% CI: −9.8 to −0.9 and Coefficient−5.5, 95% CI: −10 to−0.9, respectively) and EC (Coefficient−5.6, 95%
CI: −9.5 to−1.8 and Coefficient−6.7, 95% CI: −10.6 to−2.7, respectively) after controlling for confounders.
Conclusion: The neonatal I–V IPL is a predictor of language development at 3 years of age in preterms.