Abstract：
Studies on risk factors for childhood hearing loss (HL) are usually based on questionnaires or small sample sizes. We conducted a nationwide population-based case-control study to comprehensively analyze the maternal, perinatal, and postnatal risk factors for HL in full-term children.
We retrieved data from three nationwide databases related to maternal characteristics, perinatal comorbidities, and postnatal characteristics and adverse events. We used 1:5 propensity score matching to include 12,873 full-term children with HL and 64,365 age-, sex-, and enrolled year-matched controls. Conditional logistic regression was used to evaluate the risk factors for HL.
Among the various maternal factors, maternal HL (adjusted odds ratio [aOR]: 8.09, 95% confidence interval [95% CI]: 7.16-9.16) and type 1 diabetes (aOR: 3.79, 95% CI: 1.98-7.24) had the highest odds of childhood hearing impairment. The major perinatal risk factors for childhood hearing impairment included ear malformations (aOR: 58.78, 95% CI: 37.5-92.0) and chromosomal anomalies (aOR: 6.70, 95% CI: 5.25-8.55), and the major postnatal risk factors included meningitis (aOR: 2.08, 95% CI: 1.18-3.67) and seizure (aOR: 3.71, 95% CI: 2.88-4.77). Other factors included acute otitis media, postnatal ototoxic drug use, and congenital infections.
Many risk factors for childhood HL identified in our study are preventable, such as congenital infection, meningitis, ototoxic drug use, and some maternal comorbidities. Accordingly, more effort is required to prevent and control the severity of maternal comorbidities during pregnancy, initiate genetic diagnostic evaluation for high-risk children, and aggressive screening for neonatal infections.
We retrieved data from three nationwide databases related to maternal characteristics, perinatal comorbidities, and postnatal characteristics and adverse events. We used 1:5 propensity score matching to include 12,873 full-term children with HL and 64,365 age-, sex-, and enrolled year-matched controls. Conditional logistic regression was used to evaluate the risk factors for HL.
Among the various maternal factors, maternal HL (adjusted odds ratio [aOR]: 8.09, 95% confidence interval [95% CI]: 7.16-9.16) and type 1 diabetes (aOR: 3.79, 95% CI: 1.98-7.24) had the highest odds of childhood hearing impairment. The major perinatal risk factors for childhood hearing impairment included ear malformations (aOR: 58.78, 95% CI: 37.5-92.0) and chromosomal anomalies (aOR: 6.70, 95% CI: 5.25-8.55), and the major postnatal risk factors included meningitis (aOR: 2.08, 95% CI: 1.18-3.67) and seizure (aOR: 3.71, 95% CI: 2.88-4.77). Other factors included acute otitis media, postnatal ototoxic drug use, and congenital infections.
Many risk factors for childhood HL identified in our study are preventable, such as congenital infection, meningitis, ototoxic drug use, and some maternal comorbidities. Accordingly, more effort is required to prevent and control the severity of maternal comorbidities during pregnancy, initiate genetic diagnostic evaluation for high-risk children, and aggressive screening for neonatal infections.
摘要：
背景：关于儿童听力损失（HL）危险因素的研究通常基于问卷调查或小样本量。我们进行了一项全国人群病例对照研究，全面分析了孕产妇、围产期,和足月儿童出生后HL的危险因素。
方法：我们从三个全国性数据库中检索到与母亲特征相关的数据，围产期合并症,以及产后特征和不良事件。我们使用1：5倾向得分匹配，包括12,873名足月儿童HL和64,365年龄-，sex-,和登记的年份匹配的对照。采用条件logistic回归分析HL的危险因素。
结果：在各种母体因素中，产妇HL(校正比值比[aOR]:8.09,95%置信区间[95%CI]:7.16~9.16)和1型糖尿病(aOR:3.79,95%CI:1.98~7.24)患儿童听力障碍的几率最高.儿童听力障碍的主要围产期危险因素包括耳朵畸形（aOR：58.78，95％CI：37.5-92.0）和染色体异常（aOR：6.70，95％CI：5.25-8.55），主要的产后危险因素包括脑膜炎(aOR:2.08,95%CI:1.18-3.67)和癫痫发作(aOR:3.71,95%CI:2.88-4.77)。其他因素包括急性中耳炎，产后使用耳毒性药物，和先天性感染。
结论：在我们的研究中发现的儿童HL的许多危险因素是可以预防的，比如先天性感染，脑膜炎,使用耳毒性药物，和一些产妇合并症。因此，需要更多的努力来预防和控制怀孕期间产妇合并症的严重程度，启动高危儿童的基因诊断评估，和积极筛查新生儿感染。
方法：我们从三个全国性数据库中检索到与母亲特征相关的数据，围产期合并症,以及产后特征和不良事件。我们使用1：5倾向得分匹配，包括12,873名足月儿童HL和64,365年龄-，sex-,和登记的年份匹配的对照。采用条件logistic回归分析HL的危险因素。
结果：在各种母体因素中，产妇HL(校正比值比[aOR]:8.09,95%置信区间[95%CI]:7.16~9.16)和1型糖尿病(aOR:3.79,95%CI:1.98~7.24)患儿童听力障碍的几率最高.儿童听力障碍的主要围产期危险因素包括耳朵畸形（aOR：58.78，95％CI：37.5-92.0）和染色体异常（aOR：6.70，95％CI：5.25-8.55），主要的产后危险因素包括脑膜炎(aOR:2.08,95%CI:1.18-3.67)和癫痫发作(aOR:3.71,95%CI:2.88-4.77)。其他因素包括急性中耳炎，产后使用耳毒性药物，和先天性感染。
结论：在我们的研究中发现的儿童HL的许多危险因素是可以预防的，比如先天性感染，脑膜炎,使用耳毒性药物，和一些产妇合并症。因此，需要更多的努力来预防和控制怀孕期间产妇合并症的严重程度，启动高危儿童的基因诊断评估，和积极筛查新生儿感染。
