The effect of intrauterine exposure to aminoglycosides on neonatal hearing

The ototoxic potential of aminoglycosides has limited their use. Although their effects on adult hearing have been extensively studied, there is limited research on their potential effects on newborns following intrauterine exposure. However, aminoglycosides are commonly used to treat urinary tract infections during pregnancy.

Evaluate the incidence of sensorineural hearing loss (SNHL) in neonates who were exposed to aminoglycosides in utero. A cohort of children born between 2018 and 2024 at a single urban hospital was analysed; all underwent universal hearing screening and, if necessary, a complete diagnostic audiological evaluation. Hearing test results of newborns whose mothers were exposed to aminoglycosides in utero were compared with those of unexposed newborns.

A total of 39 237 newborns were included in the study. Of these, 85 were exposed in utero to aminoglycosides: gentamicin (13, 34 and 33 in first, second and third trimesters, respectively) or amikacin (3 and 4 in second and third trimesters, respectively), for a mean of three doses. Exposed children had significantly higher rates of other risk factors for hearing loss, including prolonged ICU stay, low birth weight and a family history of hearing loss. However, no exposed newborns developed SNHL, compared to 100 unexposed newborns.

Among 85 children exposed to aminoglycosides in utero, mostly to gentamicin, no cases of congenital SNHL were observed, despite the higher prevalence of other risk factors. Although limited by a relatively small number of aminoglycoside exposures, these findings suggest that short courses of aminoglycosides during pregnancy are not likely to be associated with increased risk of congenital SNHL.