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The prevention of sensori neural deafness
Insights
Preventing maternal rubella virus infection through vaccination offers the greatest opportunity to reduce congenital sensori-neural deafness. Early intervention and monitoring are crucial for affected infants.
Area of Science:
- Audiology
- Public Health
- Genetics
Background:
- Congenital sensori-neural deafness remains a significant concern.
- Previous efforts have successfully reduced deafness linked to the rhesus factor.
- Special care units show fewer cases of severe sensori-neural deafness in admitted infants.
Purpose of the Study:
- To review the current understanding of congenital sensori-neural deafness causes.
- To identify key areas for reducing the incidence of congenital deafness.
- To evaluate the impact of rubella prevention and prematurity on deafness.
Main Methods:
- Literature review and synthesis of existing data on congenital deafness.
- Analysis of factors contributing to sensori-neural hearing loss in newborns.
- Examination of the relationship between maternal infections, prematurity, and infant hearing.
Main Results:
- Rubella virus prevention through vaccination presents the most significant opportunity for reducing congenital deafness.
- Maternal rubella vaccination could prevent deafness in up to one-third of affected children.
- The link between prematurity and congenital sensori-neural deafness is less clear, with recent data suggesting it's not a primary factor.
- Establishment of a heartbeat at birth may be more critical than oxygen levels for preventing hearing loss.
Conclusions:
- Vigorous rubella vaccination programs are essential for preventing congenital sensori-neural deafness.
- The effectiveness of rubella immunization may reduce the need for abortions related to suspected maternal infection.
- Further research is needed to clarify the role of prematurity and birth complications in congenital hearing loss.
- Genetic counseling for deaf school leavers is being considered as a supportive measure.
Abstract:
A review of the present position concerning the causes of congenital sensori-neural deafness has been presented. Significant success has been achieved in the reduction, if not the elimination, of congenital deafness arising from the rhesus factor. Indications are that babies admitted to special care units show few children with severe sensori-neural deafness. The greatest opportunity for a significant reduction in the incidence of congenital sensori-neural deafness lies in the prevention of maternal infection by the rubella virus. There is a possibility that deafness could be avoided in many as one third of children so born if a vigorous vaccination programme is pursued. If the number of women undergoing abortion for suspected rubella continues at the same annual rate the reduction of children born deaf as a result of the rubella virus will anticipate the reduction which could be expected for an effective immunization programme. If the immunization programme can be fully implemented the need for abortion will decline. The relationship of prematurity and deafness is an area where doubt must still remain. Although some statistics have stressed the relationship between prematurity and congenital sensori-neural deafness, the latest study reported indicates that for the last four years prematurity has not featured as a significant concomitant factor. On the other hand, it does appear that, in the study of D'Souza, McCartney, Nolan and Taylor (1980) of the 26 babies who took ten minutes or more to establish spontaneous respiration, the one baby found to have a hearing loss was one of two babies who had no vital signs at birth. It may be that the establishment of a heart beat is even more significant than oxygen lack. Consideration of the value of offering genetic counselling to deaf school leavers is under consideration.