Department of Health Sciences, School of Sciences, European University Cyprus, Diogenis Str 6, Nicosia, 2404, Cyprus.
Int J Pediatr Otorhinolaryngol. 2021 Aug;147:110801. doi: 10.1016/j.ijporl.2021.110801. Epub 2021 Jun 12.
Identification of the factors that could potentially lead to congenital hearing loss is of paramount importance, as early detection of congenital hearing loss and intervention could prevent developmental delays in speech, language development as well as childhood cognitive impairment. Hitherto, intrauterine exposure to Zika virus has emerged as a cause of various fetal malformations, including cases of congenital hearing loss. The aim of this systematic review is to investigate the association between intrauterine exposure to Zika virus and hearing loss in children.
A systematic literature search was conducted to the databases PubMed, Cochrane library, Scopus, ClinicalTrials.gov, SciELO and Lilacs in order to identify studies that examine the association between prenatally Zika exposure and hearing loss within the first few years of life. Studies were eligible for inclusion, if solely objective methods for hearing evaluation of patients such as otoacoustic emissions (OAEs) and/or auditory brainstem response (ABR) were used, in children who intrauterine exposed to the Zika virus.
Thirteen studies were included, which included 1275 children who are prenatally exposed to Zika virus. In 852 of the cases an objective hearing evaluation was performed using either OAEs or ABR. 709 children were tested with ABR and 79 had a failed outcome. 143 children were tested with OAEs whilst of these, 30 had a failed outcome. Altered OAEs ranged from 8.7% to 30.2%, while altered ABR ranged from 0% to 19.9%. The initial sample includes 428 children with microcephaly, while 5 of the studies comprise microcephaly to the inclusion criteria.
It seems to be a possible association between prenatal Zika virus exposure and hearing loss in children during the first years of their life. It is of great importance that in future studies possible confounding factors, like microcephaly, will be appropriately controlled. Additionally, the follow-up period of monitoring hearing loss in children should be prolonged in order to identify potential late onset hearing problems caused by intrauterine exposure to Zika virus.
识别可能导致先天性听力损失的因素至关重要，因为早期发现先天性听力损失并进行干预可以防止儿童言语、语言发育迟缓以及认知障碍。迄今为止，子宫内接触寨卡病毒已成为各种胎儿畸形的原因，包括先天性听力损失病例。本系统评价的目的是研究子宫内接触寨卡病毒与儿童听力损失之间的关系。
对 PubMed、Cochrane 图书馆、Scopus、ClinicalTrials.gov、SciELO 和 Lilacs 数据库进行系统文献检索，以确定检查宫内接触寨卡病毒与出生后前几年听力损失之间关系的研究。如果仅使用客观的患者听力评估方法，如耳声发射（OAE）和/或听性脑干反应（ABR），研究即符合纳入标准，这些方法用于评估子宫内暴露于寨卡病毒的儿童。
共纳入 13 项研究，其中包括 1275 名子宫内暴露于寨卡病毒的儿童。在 852 例病例中，使用 OAE 或 ABR 对患者进行了客观听力评估。709 例儿童接受了 ABR 测试，其中 79 例测试结果异常。143 例儿童接受了 OAE 测试，其中 30 例测试结果异常。改变的 OAE 范围为 8.7%至 30.2%，而改变的 ABR 范围为 0%至 19.9%。初始样本包括 428 名小头畸形儿童，其中 5 项研究的纳入标准包括小头畸形。
子宫内接触寨卡病毒与儿童在生命最初几年的听力损失之间似乎存在关联。在未来的研究中，非常重要的是适当控制可能的混杂因素，如小头畸形。此外，应延长儿童听力损失监测的随访期，以识别因子宫内接触寨卡病毒而导致的潜在迟发性听力问题。
