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Predisposing Factors for Congenital Hearing Loss: A Comprehensive Systematic Review
Taruni Lalchandani1, Ashish Chandra Agarwal1, Shiva Tiwari2
1Dr. Ram Manohar Lohia Institute of Medical Sciences, Department of Otorhinolaryngology, Uttar Pradesh, India.
Insights
Congenital hearing loss (CHL) is often caused by genetic factors and infections like cytomegalovirus. Early detection and prevention strategies targeting these key risk factors are essential for managing CHL in children.
Area of Science:
- Otolaryngology
- Genetics
- Pediatrics
Background:
- Congenital hearing loss (CHL) is a significant global health concern.
- Identifying risk factors is crucial for prevention and early intervention.
- CHL has diverse etiologies, including genetic, infectious, perinatal, and environmental factors.
Purpose of the Study:
- To systematically review and synthesize research on risk factors for congenital hearing loss (CHL).
- To emphasize genetic, infectious, perinatal, environmental, and sociodemographic influences on CHL.
- To inform targeted screening and preventive strategies for CHL.
Main Methods:
- Systematic review adhering to PRISMA 2020 and PRISMA-S guidelines.
- Comprehensive literature search across PubMed, Embase, Scopus, and Google Scholar.
- Inclusion of observational studies assessing CHL risk factors; risk of bias evaluation using established tools.
Main Results:
- Genetic factors (e.g., GJB2 mutations, family history, consanguinity) and infections (e.g., congenital cytomegalovirus, TORCH) are prevalent causes of CHL.
- Perinatal issues (NICU admission, low birth weight, hyperbilirubinemia) and ototoxic medication exposure are significant risk factors.
- Sensorineural hearing loss, predominantly bilateral, is the most common type reported.
Conclusions:
- Congenital hearing loss is a multifactorial condition with significant genetic and infectious contributions.
- Effective management requires targeted screening and preventive measures addressing identified risk domains.
- Further research can refine understanding and improve outcomes for children with CHL.
Abstract:
This systematic review aimed to assess and integrate research on risk factors for congenital hearing loss (CHL), emphasizing genetic, infectious, perinatal, environmental, and sociodemographic influences. The review was prospectively registered with PROSPERO (CRD42022372879) and conducted according to PRISMA 2020 and PRISMA-S guidelines. A comprehensive search was performed across PubMed, Embase, Scopus, and Google Scholar using MeSH terms and free-text keywords related to CHL and its risk factors. Observational studies (cohort, case-control, cross-sectional) involving children with CHL and assessing genetic, infectious, perinatal, or environmental exposures were included. Data extraction was done independently by two reviewers, covering study characteristics, diagnostic methods, and measures of association (odds ratio, relative risk). Risk of bias was evaluated using the Newcastle-Ottawa scale for cohort/case-control studies and the Joanna Briggs Institute checklist for cross-sectional studies. Genetic factors such as GJB2 mutations, a positive family history, and consanguinity were consistently associated with CHL. Infectious etiologies, particularly congenital cytomegalovirus, were prominent across studies, with TORCH infections also commonly implicated. Perinatal risk factors, including neonatal intensive care unit admission, low birth weight, and hyperbilirubinemia, were frequently reported in affected children. Environmental exposures, especially to ototoxic medications, were noted as significant contributors, often acting synergistically with other risk factors like infections or genetic conditions. Sensorineural hearing loss, predominantly bilateral, emerged as the most common type reported. CHL is a multifactorial condition, with genetic and infectious causes being most prevalent. Targeted screening and preventive strategies addressing these risk domains are crucial for early detection and management.
