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糖尿病孕妇所生孩子的听力结果。

Hearing outcomes in children of diabetic pregnancies.

机构信息

Department of Otolaryngology, Head and Neck Surgery, Medical University of South Carolina, Charleston, SC, USA.

Department of Otolaryngology, Head and Neck Surgery, Medical University of South Carolina, Charleston, SC, USA.

出版信息

Int J Pediatr Otorhinolaryngol. 2020 May;132:109925. doi: 10.1016/j.ijporl.2020.109925. Epub 2020 Feb 1.

Abstract

OBJECTIVE

Children of diabetic pregnancies (CDPs) face numerous risk factors for hearing loss (HL). The objective of this study was to investigate the hearing outcomes of CDPs on a population scale.

METHODS

Using the Audiological and Genetic Database, the prevalence, severity, and progression of HL in CDPs was compared against children of non-diabetic pregnancies (CNDPs) who served as controls.

RESULTS

Among 311 CDPs, 71.1% demonstrated evidence of HL compared to 45.5% in CNDPs (p < 0.001). The mean age at which CDPs received audiograms was 3.6 years compared to 5.4 years for CNDPs (p < 0.001). Compared to CNDPs, CDPs were similarly affected by common otologic conditions such as acute otitis media (25.7%), chronic otitis media (38.3%), and Eustachian tube dysfunction (41.8%) (all p > 0.05). CDPs were more likely to have bilateral HL (81%) and sensorineural hearing loss (SNHL) (8%) relative to CNDPs (p < 0.001 and p = 0.004, respectively). Rates of conductive HL and mixed HL were not significantly different between groups (p = 0.952 and p = 0.058, respectively). CDPs were at significant risk for the development of HL (aOR 1.66 [1.28-2.17], SNHL (aOR 1.63 [1.01-2.52], and high-frequency HL (aOR 1.32 [1.03-1.68]). Of the comorbidities evaluated, CDPs with hyperbilirubinemia (aOR 1.85 [1.18-2.84]), perinatal asphyxia (aOR 1.90 [1.06-3.16]), or congenital heart disease (aOR 1.21 [1.07-1.37]) demonstrated higher risk of SNHL.

CONCLUSION

Children of diabetic pregnancies face increased risks of developing HL, particularly bilateral and sensorineural hearing loss. Given these findings, we recommend close audiologic follow-up for these children, especially those with complicated birth histories or additional medical problems.

摘要

目的

糖尿病孕妇所生的儿童(CDP)面临许多听力损失(HL)的风险因素。本研究的目的是在人群范围内研究 CDP 的听力结果。

方法

使用听力和遗传数据库,将 HL 在 CDP 中的患病率、严重程度和进展与作为对照的非糖尿病孕妇所生的儿童(CNDP)进行比较。

结果

在 311 名 CDP 中,有 71.1%的人有证据表明存在 HL,而 CNDP 为 45.5%(p<0.001)。CDP 接受听力图的平均年龄为 3.6 岁,而 CNDP 为 5.4 岁(p<0.001)。与 CNDP 相比,CDP 同样受到常见的耳科疾病的影响,如急性中耳炎(25.7%)、慢性中耳炎(38.3%)和咽鼓管功能障碍(41.8%)(所有 p>0.05)。与 CNDP 相比,CDP 更有可能双侧 HL(81%)和感音神经性听力损失(SNHL)(8%)(p<0.001 和 p=0.004)。两组之间传导性 HL 和混合性 HL 的发生率无显著差异(p=0.952 和 p=0.058)。CDP 发生 HL(优势比[OR]1.66[1.28-2.17])、SNHL(OR 1.63[1.01-2.52])和高频 HL(OR 1.32[1.03-1.68])的风险显著增加。在所评估的合并症中,胆红素升高(OR 1.85[1.18-2.84])、围产期窒息(OR 1.90[1.06-3.16])或先天性心脏病(OR 1.21[1.07-1.37])的 CDP 发生 SNHL 的风险更高。

结论

糖尿病孕妇所生的儿童发生 HL 的风险增加,特别是双侧和感音神经性听力损失。鉴于这些发现,我们建议对这些儿童进行密切的听力随访,特别是那些有复杂的分娩史或其他医疗问题的儿童。

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