Risk Factors for Childhood Sensorineural Hearing Loss in the Oxford Region

Abstract

We have used a comprehensive register of hearing-impaired children born in the former Oxford Health Region to study risk factors for sensorineural hearing loss. The occurrence of a wide variety of risk factors was documented from the case notes of 145 children; these were all the cases known at the time of the study with all degrees of hearing loss born between 1984 and 1988. Comparison with the normal Regional population showed that maternal age over 35 years and Asian ethnic origin were significant risk factors for congenital (non-acquired) hearing loss (odds ratio 1.7 and 2.5 respectively). Black/Asian children were also significantly more likely to have acquired losses. Low birthweight (below 2500 g) also gave a significantly increased risk, with an odds ratio of 4.5, rising to 9.6 for birthweight less than 1500 g. We also found that significantly more hearing-impaired cases were in lower social classes compared with the general population. A high proportion of cases (24%) had cranio-facial abnormalities (CFA), including many non-aural abnormalities and dysmorphic features, which therefore should be counted as high risk. Hearing losses acquired due to perinatal causes were almost all mild or moderate. Four factors-admission to special care baby unit for more than 72 hours, CFA, family history, and meningitis-accounted for 69% of all cases in this study. Targeted neonatal screening based on the first three factors, plus obligatory testing following meningitis, therefore, should be highly efficient at detecting deafness early.

Current practice, accuracy, effectiveness and cost-effectiveness of the school entry hearing screen

“…The level of deprivation 36 and Asian ethnic background 13 are both factors that have been found to increase the odds ratio for PCHI within a community, and inward flow of children into the district from abroad after the newborn or infant screens, and before school entry, are characteristics that are not uniform nationwide. Nevertheless, they are pertinent to the wider interpretation of the current data.…”

“…All studies received an 'unclear' for this question as none of them clearly states what data were available to them at the time of testing. [30][31][32][33][34][35][36][37]. The two-by-two tables for sensitivity and specificity, where available, are presented in Appendix 10.…”

Birth Weight and Hearing Impairment in Norwegians Born From 1967 to 1993

“…[1][2][3][4][5][6][7][8][9][10][11][12] Several studies have shown that children who at birth had very low birth weight have increased risk of severe hearing impairment. [13][14][15] Less attention has been given the association between birth weight and hearing impairment in general taking into consideration other pregnancy-related conditions, which may represent causal factors in the development of hearing. A large and representative population is therefore required to assess the effects of birth weight per se.…”

Newborn hearing screening project using transient evoked otoacoustic emissions: Western Sicily experience

“…We also considered a perinatal risk factors: cranio-facial abnormality, birth weight <1500 g, hyperbilirubinaemia, low apgar scores, mechanical ventilation !5 days and neonatal intensive care >48 h [8,[31][32][33]. In this way we were able to divide all the newborns into two groups: newborn with risk factor and newborn without risk factor.…”

“…Hearing loss is one of the commonest disorders present at birth; the literature report a large range of childhood hearing impairment (PCHI) from 0.7 to 4.2/1000 live births [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16]; it is probably due to many elements that each author studied: unilateral or bilateral hearing loss; severity of hearing loss; age, sex, ethnicity and socio-economic status in a particular population; presence in the group observed of prenatal and perinatal risk factors.…”