关键词: Congenital heart defect Diabetes mellitus Gestational Health of newborn infants Hearing loss Infant of diabetic mother Premature infants

Mesh : Asphyxia Neonatorum / epidemiology Case-Control Studies Child Child, Preschool Chronic Disease Comorbidity Diabetes Mellitus / epidemiology Female Hearing Loss / epidemiology Hearing Loss, Bilateral / epidemiology Hearing Loss, Conductive / epidemiology Hearing Loss, Sensorineural / epidemiology Hearing Tests Heart Defects, Congenital / epidemiology Humans Hyperbilirubinemia / epidemiology Infant Male Otitis Media / epidemiology Pregnancy Pregnancy in Diabetics / epidemiology Prevalence Risk Factors United States / epidemiology

来  源:   DOI:10.1016/j.ijporl.2020.109925   PDF(Sci-hub)

Abstract:
OBJECTIVE: Children of diabetic pregnancies (CDPs) face numerous risk factors for hearing loss (HL). The objective of this study was to investigate the hearing outcomes of CDPs on a population scale.
METHODS: Using the Audiological and Genetic Database, the prevalence, severity, and progression of HL in CDPs was compared against children of non-diabetic pregnancies (CNDPs) who served as controls.
RESULTS: Among 311 CDPs, 71.1% demonstrated evidence of HL compared to 45.5% in CNDPs (p < 0.001). The mean age at which CDPs received audiograms was 3.6 years compared to 5.4 years for CNDPs (p < 0.001). Compared to CNDPs, CDPs were similarly affected by common otologic conditions such as acute otitis media (25.7%), chronic otitis media (38.3%), and Eustachian tube dysfunction (41.8%) (all p > 0.05). CDPs were more likely to have bilateral HL (81%) and sensorineural hearing loss (SNHL) (8%) relative to CNDPs (p < 0.001 and p = 0.004, respectively). Rates of conductive HL and mixed HL were not significantly different between groups (p = 0.952 and p = 0.058, respectively). CDPs were at significant risk for the development of HL (aOR 1.66 [1.28-2.17], SNHL (aOR 1.63 [1.01-2.52], and high-frequency HL (aOR 1.32 [1.03-1.68]). Of the comorbidities evaluated, CDPs with hyperbilirubinemia (aOR 1.85 [1.18-2.84]), perinatal asphyxia (aOR 1.90 [1.06-3.16]), or congenital heart disease (aOR 1.21 [1.07-1.37]) demonstrated higher risk of SNHL.
CONCLUSIONS: Children of diabetic pregnancies face increased risks of developing HL, particularly bilateral and sensorineural hearing loss. Given these findings, we recommend close audiologic follow-up for these children, especially those with complicated birth histories or additional medical problems.
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