母亲接触药物与儿童先天性及早发性听力损失风险：一项系统评价与荟萃分析
Maternal Exposure to Medications and the Risk of Congenital and Early-Onset Hearing Loss in Children: A Systematic Review and a Meta-Analysis.
作者信息
Kücükyildiz Asli Sena, Thunbo Mette Østergaard, Swan Christer Zøylner, Burgner David P, Miller Jessica E, Ovesen Therese, Pedersen Lars Henning
机构信息
Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.
Department of Obstetrics and Gynaecology, Aarhus University Hospital, Aarhus, Denmark.
出版信息
Basic Clin Pharmacol Toxicol. 2025 Sep;137(3):e70090. doi: 10.1111/bcpt.70090.
BACKGROUND
Congenital hearing loss (CHL) affects approximately 1-2 in 1000 children and significantly impacts development. Exposure to medications during pregnancy may impact offspring hearing; however, the ototoxic effects of different drugs have not been systematically investigated.
METHODS
This systematic review and meta-analysis was conducted following PRISMA guidelines and analysed 21 experimental and observational studies examining 60 drugs across various categories.
FINDINGS
Magnesium sulphate and systemic steroids, alone or in combination, showed potential protective effects towards CHL. Specific antibiotics (e.g., gentamicin and metronidazole) and non-steroidal anti-inflammatory drugs were associated with an increased risk of CHL. Modest evidence indicated that low-dose acetylsalicylic acid increased risk, whereas higher doses did not. Other drugs, such as anti-neoplastic agents and valproic acid, showed weaker associations with CHL. Most studies had methodological limitations.
CONCLUSION
Our findings highlight the urgent need for robust research to minimise preventable hearing loss in children.
背景
先天性听力损失（CHL）影响约千分之一至千分之二的儿童，并对其发育产生重大影响。孕期接触药物可能会影响子代听力；然而，不同药物的耳毒性作用尚未得到系统研究。
方法
本系统评价和荟萃分析按照PRISMA指南进行，分析了21项实验性和观察性研究，这些研究涉及各类60种药物。
结果
硫酸镁和全身性类固醇单独或联合使用对CHL显示出潜在的保护作用。特定抗生素（如庆大霉素和甲硝唑）和非甾体抗炎药与CHL风险增加相关。有适度证据表明低剂量乙酰水杨酸会增加风险，而高剂量则不会。其他药物，如抗肿瘤药和丙戊酸，与CHL的关联较弱。大多数研究存在方法学局限性。
结论
我们的研究结果凸显了开展有力研究以尽量减少儿童可预防听力损失的迫切需求。
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