Risk Factors for Hearing Loss Are Comparable in Preterm Versus Term Children: A Systematic Review
Pauline Roehrs1, Anna-Katharina Rohlfs2, Reinhard Vonthein3
1Department of Paediatrics, University Hospital of Luebeck, Luebeck, Germany.
Insights
Prematurity itself may not independently increase hearing loss risk. While preterm infants face more neonatal risk factors, evidence on differing risk factor effects between preterm and term infants remains inconclusive.
Area of Science:
- Pediatrics
- Audiology
- Neonatology
Background:
- Hearing loss is more prevalent in preterm children.
- The independent contribution of prematurity to hearing loss risk is not well understood.
Purpose of the Study:
- To investigate if risk factors for hearing loss differ between preterm and term infants.
- To clarify the role of prematurity as an independent risk factor for hearing impairment.
Main Methods:
- Systematic literature search of three databases (March 2023).
- Inclusion of studies comparing hearing loss risk factors in preterm and term children.
- Logistic regression analysis to determine odds ratios (95% confidence interval).
Main Results:
- 16 studies including 9059 preterm and 10048 term children were analyzed.
- One study indicated increased risk for mechanical ventilation, sepsis, and ototoxic medication in preterm infants.
- No significant differences in risk factors were found when shared by both groups, suggesting prematurity may not be an independent factor.
Conclusions:
- Current evidence on differing effect sizes of risk factors in preterm versus term infants is inconclusive.
- Preterm infants accumulate a higher burden of risk factors during the neonatal period.
Aim:
Hearing loss occurs more frequently in preterm children. However, the influence of prematurity itself is unclear. We examined whether risk factors for hearing loss differ between preterm and term infants.
Methods:
We conducted a systematic search of three databases in March 2023 for studies comparing risk factors for hearing loss in preterm and term children. Studies on postnatal trauma, chemotherapy or infections after the age of 5 years were excluded. Risk of bias was assessed. Data were extracted and analyzed using logistic regression to yield odds ratios (95% confidence interval).
Results:
Of 10 300 studies screened, 16 met the inclusion criteria, including 9059 preterm and 10 048 term children. Only one study compared risk factors between preterm and term infants as primary outcomes. It identified an increased risk in the preterm but not term group with mechanical ventilation exceeding 5 days, sepsis, and ototoxic medication. No significant differences were found when both groups shared these risk factors, suggesting that prematurity may not be an independent risk factor. Other studies reported variable results.
Conclusion:
Evidence of different effect sizes of risk factors in preterm and term children remains inconclusive. Preterm children acquire more risk factors in the neonatal period.
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