P Amrutha, G Nayana V, Sequeira Nimalka Maria, S Hemaraj Nayaka
Department of Otorhinolaryngology, Yenepoya Medical College, Deralakatte, Dakshina Kannada, Mangalore, Karnataka India.
Department of Audiology and Speech Language Pathology, Yenepoya Medical College Deralakatte, Deralakatte, Dakshina Kannada, Mangalore, Karnataka India.
Indian J Otolaryngol Head Neck Surg. 2024 Apr;76(2):1741-1746. doi: 10.1007/s12070-023-04393-x. Epub 2024 Jan 11.
Gestational diabetes is a potential risk factor for neonatal hearing loss. Increased circulating sugars in mothers during pregnancy can impairs the micro circulation and can cause congenital anomalies of the inner ear resulting in congenital hearing loss. This study attempts to find the incidence of neonatal hearing loss among diabetic mothers.
This was a case control study with 86 neonates of diabetic mothers as cases and neonates of non diabetic mothers(n = 86) as controls. Antenatal diabetic history and sugar values of mothers were documented. Hearing status of the neonates were tested using DPOAE test and ABR test. DPOAE test was done on 3rd day and those who did not get a positive response underwent 2nd DPOAE and also ABR test if 2nd DPOAE was negative.
All neonates underwent DPOAE test and few were lost on follow up. First and second DPOAE showed a statistically significant difference between cases and controls. All babies who underwent ABR test had abnormal waveforms. 98% of cases showed moderate and severe bilateral hearing loss whereas all controls had only mild bilateral hearing loss.
This study showed a significantly higher percentage of abnormal hearing outcome among neonates of diabetic mothers than non diabetic mothers. This could be because of the toxic effects of maternal hyperglycemia on developing auditory system of the fetus. This study emphasis the need for better glycaemic control in diabetic pregnancy, the importance of early and mandatory hearing screening in newborns of diabetic mothers.
妊娠期糖尿病是新生儿听力损失的一个潜在风险因素。孕期母亲体内循环血糖升高会损害微循环，并可导致内耳先天性异常，从而造成先天性听力损失。本研究试图找出糖尿病母亲所生新生儿中听力损失的发生率。
这是一项病例对照研究，以86例糖尿病母亲所生新生儿为病例组，86例非糖尿病母亲所生新生儿为对照组。记录母亲的产前糖尿病病史和血糖值。使用畸变产物耳声发射（DPOAE）测试和听性脑干反应（ABR）测试对新生儿的听力状况进行检测。在出生第3天进行DPOAE测试，未得到阳性反应者接受第二次DPOAE测试，若第二次DPOAE测试为阴性则同时进行ABR测试。
所有新生儿均接受了DPOAE测试，少数在随访中失访。第一次和第二次DPOAE测试显示病例组和对照组之间存在统计学显著差异。所有接受ABR测试的婴儿波形均异常。98%的病例组显示中度和重度双侧听力损失，而所有对照组仅为轻度双侧听力损失。
本研究表明，糖尿病母亲所生新生儿听力异常结果的比例显著高于非糖尿病母亲所生新生儿。这可能是由于母亲高血糖对胎儿发育中的听觉系统产生了毒性作用。本研究强调了糖尿病妊娠中更好地控制血糖的必要性，以及对糖尿病母亲所生新生儿进行早期和强制性听力筛查的重要性。
