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Risk factors for childhood sensorineural hearing loss in the Oxford region
1Audiology Department, Royal Berkshire Hospital NHS Trust, Reading, UK.
Insights
Maternal age over 35, Asian ethnicity, and low birthweight are key risk factors for congenital hearing loss in children. Early detection through targeted neonatal screening is crucial.
Area of Science:
- Pediatrics
- Genetics
- Public Health
Background:
- Sensorineural hearing loss (SNHL) is a significant congenital disability.
- Identifying risk factors is crucial for early intervention and prevention strategies.
Purpose of the Study:
- To investigate risk factors associated with sensorineural hearing loss in children.
- To evaluate the effectiveness of targeted neonatal screening for early detection.
Main Methods:
- Utilized a comprehensive register of hearing-impaired children born in the Oxford Health Region (1984-1988).
- Documented risk factors from case notes of 145 children with all degrees of hearing loss.
- Compared findings with the general population to identify significant risk factors.
Main Results:
- Maternal age over 35 (OR 1.7) and Asian ethnicity (OR 2.5) were significant risk factors for congenital hearing loss.
- Low birthweight (<2500g, OR 4.5; <1500g, OR 9.6) significantly increased SNHL risk.
- Craniofacial abnormalities (CFA) were present in 24% of cases; admission to SCBU >72h, CFA, family history, and meningitis accounted for 69% of cases.
Conclusions:
- Maternal age, ethnicity, low birthweight, social class, and CFA are significant risk factors for childhood SNHL.
- Targeted neonatal screening based on specific risk factors (SCBU admission, CFA, family history) and meningitis testing can efficiently detect early-onset deafness.
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.