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Qian H, Yang H. Risk Factors, Complications, and Treatment Modalities for Sudden Sensorineural Hearing Loss in Pregnant Women: A Systematic Review and Meta-analysis. Noise Health 2024; 26:205-213. [PMID: 38904824 DOI: 10.4103/nah.nah_62_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 02/21/2024] [Indexed: 06/22/2024] Open
Abstract
BACKGROUND Sudden sensorineural hearing loss (SSNHL) during pregnancy is a rare condition and has not been much studied. The study aimed to perform a systematic review and meta-analysis of the risk factors, complications, and treatment modalities for SSNHL in pregnant women. MATERIALS AND METHODS PubMed, Web of Science, Scopus, ProQuest, and Google Scholar were used for the literature search. The Cochrane technique for assessing risk of bias was used for the article quality appraisal, and RevMan 5.4 was used for conducting the meta-analysis. Standard mean difference (SMD) and odds ratios with a 95% confidence interval (95% CI) were utilized. Heterogeneity and publication bias were assessed using the I-square (I2) test statistic and the Egger's test, respectively. RESULTS AND DISCUSSION The seven primary studies employed prospective and retrospective study designs. The meta-analysis showed that there were fewer risk variables for SSNHL in the experimental group compared with those in the control group (SMD = -0.45 to 3.24, 95% CI = -3.063.63 to 2.16-2.85), indicating that the analysis revealed an insignificant difference. However, the treated patients presented hearing improvement, suggesting a significant analysis (SMD = -0.6710.20, 95% CI = -1.2713.51 to -0.066.88). Furthermore, after therapy, substantial differences were observed in SMD between the two groups (SMD = -0.7415.18, 95% CI = -1.2423.85 to -0.256.40) in favor of the experimental group patients, based on the analysis results of four included studies. However, the I2-value of 0% showed that the heterogeneity was low. CONCLUSION SSNHL during pregnancy is a notably rare condition with an unknown cause. However, hormonal fluctuations, particularly increased levels of estrogen and progesterone during pregnancy, have been frequently implicated as potential triggers for SSNHL.
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Affiliation(s)
- Haibin Qian
- Department of Obstetrics and Gynecology, Wenzhou Center Hospital, Wenzhou, Zhejiang 325000, China
| | - Huaqin Yang
- Department of Obstetrics, Taizhou Central Hospital (Taizhou University Hospital), Taizhou, Zhejiang 318000, China
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Yu Y, Choi J, Lee MH, Kim K, Ryu HM, Han HW. Maternal disease factors associated with neonatal jaundice: a case-control study. BMC Pregnancy Childbirth 2022; 22:247. [PMID: 35331174 PMCID: PMC8953140 DOI: 10.1186/s12884-022-04566-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 02/28/2022] [Indexed: 12/27/2022] Open
Abstract
Background Neonatal jaundice is common, and despite the considerable medical costs associated with it, there are still few studies on the maternal factors associated with it. Identification of maternal factors associated with neonatal jaundice is very important in terms of prevention, screening and management of neonatal jaundice. The current study aimed to identify maternal disease factors associated with neonatal jaundice. Methods We compared the maternal disease diagnostic codes during pregnancy (study A) and 1 year before conception (study B) in mothers whose insurance claims data included newborns treated for neonatal jaundice before birth registration via the National Health Insurance Service–National Sample Cohort (control group). To decrease the effect of confounding variables, the neonatal jaundice and control groups were matched at a ratio of 1:10 via propensity score matching using covariates including age and income. Results The matched samples for studies A and B included 4,026 and 3,278 (jaundice group: 366 and 298) delivery cases, respectively. In both studies, the jaundice group had a higher proportion of patients who underwent cesarean section than the control group. In study A, other diseases of the digestive system had the highest odds ratio (OR) (K92; adjusted OR: 14.12, 95% confidence interval [CI]: 2.70–82.26). Meanwhile, gastritis and duodenitis had the lowest OR (K29; adjusted OR: 0.39, 95% CI: 0.22–0.69). In study B, salpingitis and oophoritis had the highest OR (N70; adjusted OR: 3.33, 95% CI: 1.59–6.94). Heartburn had the lowest OR (R12; adjusted OR: 0.29, 95% CI:0.12–0.71). Conclusions This study identified maternal disease factors correlated with neonatal jaundice during pregnancy and 1 year before conception. Maternal risk factors for neonatal jaundice included syphilis and leiomyoma during pregnancy, and salpingo-oophoritis before pregnancy. The protective factors included infection, inflammatory diseases, and dyspepsia.
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Affiliation(s)
- Youngjae Yu
- Department of Biomedical Informatics, CHA University School of Medicine, CHA University, Seongnam, Korea.,Institute for Biomedical Informatics, CHA University School of Medicine, CHA University, Seongnam, Republic of Korea
| | - Jinwha Choi
- Department of Pediatrics, Korea University College of Medicine, Seoul, Korea
| | - Myeong Hoon Lee
- Department of Biomedical Informatics, CHA University School of Medicine, CHA University, Seongnam, Korea.,Institute for Biomedical Informatics, CHA University School of Medicine, CHA University, Seongnam, Republic of Korea
| | - KangHyun Kim
- Department of Biomedical Informatics, CHA University School of Medicine, CHA University, Seongnam, Korea.,Institute for Biomedical Informatics, CHA University School of Medicine, CHA University, Seongnam, Republic of Korea
| | - Hyun Mee Ryu
- Department of Obstetrics and Gynecology, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Korea
| | - Hyun Wook Han
- Department of Biomedical Informatics, CHA University School of Medicine, CHA University, Seongnam, Korea. .,Institute for Biomedical Informatics, CHA University School of Medicine, CHA University, Seongnam, Republic of Korea.
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Audio-vestibular disorders and pregnancy: A systematic review. Am J Otolaryngol 2021; 42:103136. [PMID: 34182351 DOI: 10.1016/j.amjoto.2021.103136] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Accepted: 06/13/2021] [Indexed: 12/12/2022]
Abstract
PURPOSE During pregnancy a woman's body undergoes many physiological changes that involve all systems and organs, including sensory ones. We conducted this systematic review to highlight current evidence and treatment options in pregnant women with audio-vestibular disorders. MATERIALS AND METHODS A search was made on the following databases: PubMed, PubMed Central, Web of Science and Scopus. This research protocol was deposited in the PROSPERO Database. RESULTS After application of inclusion-exclusion criteria, 30 manuscripts were included in the review. Many authors (14/15) found a slight alteration of audiometric tests during pregnancy, with a reported recovery postpartum in most of the studies (5/7). Regarding sudden sensorineural hearing loss (SSNHL), we found four articles for a total of 69 patients: the treatment of choice was intravenous Dextran 40 and intra-tympanic corticosteroids. Most included studies (4/6) found neither clinical nor epidemiological associations between otosclerosis and pregnancy in large-based sample studies. Few investigations regarded Eustachian tube function and vertigo. CONCLUSIONS According to our results, many variations of hearing acuity during pregnancy are slight and transient and require only clinical observation. In large samples, otosclerosis appeared not to be associated with pregnancy. Clinicians should consider intra-tympanic steroids in managing SSNHL during pregnancy. Further more accurate research is needed to deepen and clarify the association between pregnancy and audio-vestibular disorders.
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Kim HS, Lee KM, Han SW, Cho GJ, Hwang HS. Risk factors associated with idiopathic sudden sensorineural hearing loss in pregnant South Korean women: a nationwide population-based study. J Matern Fetal Neonatal Med 2021; 35:7389-7394. [PMID: 34256656 DOI: 10.1080/14767058.2021.1949443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Sudden sensorineural hearing loss (SSNHL) is rare in pregnancy and can be attributed to pregnancy-induced changes in hormone levels that increase thrombogenic risk and alter cochlear microcirculation with consequent development of sudden deafness. The study aimed to analyze the risk factors associated with SSNHL in pregnant South Korean. METHODS A retrospective study of the incidence and risk factors associated with SSNHL before pregnancy enrolled 401,470 Korean women who delivered between January 2010 and December 2014. All participants underwent a pre-pregnancy national health screening examination through the National Health Insurance Corporation. We investigated the risk factors in 459 pregnant women with sudden sensorineural hearing loss and in 401,011 pregnant women without SSNHL through the pre-pregnancy national health screening examination and adverse perinatal outcome. RESULTS No statistically significant intergroup differences were observed in the maternal age, parity, method of delivery, gestational age at delivery, body mass index, blood pressure, as well as fasting blood glucose and cholesterol levels. After adjusting for maternal age, the pre-pregnancy body mass index was associated with an increased risk of sensorineural hearing loss in pregnancy (adjusted odds ratio 1.52, 95% confidence interval 1.04-2.22). The sensorineural hearing loss did not increase the risk for gestational hypertension, preterm birth (<37 weeks' gestation), small- and large-for-gestational-age infants, postpartum hemorrhage, placenta previa, and placental abruption. CONCLUSION SSNHL can occur throughout pregnancy and is associated with maternal pre-pregnancy obesity. Notably, it does not increase risks during delivery or cause adverse perinatal outcomes.
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Affiliation(s)
- Hee-Sun Kim
- Department of Obstetrics and Gynecology, Dongguk University Ilsan Hospital, Goyang, South Korea
| | - Kyu-Min Lee
- School of Industrial Management Engineering, Korea University, Seoul, South Korea
| | - Sung Won Han
- School of Industrial Management Engineering, Korea University, Seoul, South Korea
| | - Geum Joon Cho
- Department of Obstetrics and Gynecology, Korea University College of Medicine, Seoul, South Korea
| | - Han-Sung Hwang
- Department of Obstetrics and Gynecology, Konkuk University School of Medicine, Seoul, South Korea
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Lyu YL, Zeng FQ, Zhou Z, Yan M, Zhang W, Liu M, Ke ZY. Intratympanic dexamethasone injection for sudden sensorineural hearing loss in pregnancy. World J Clin Cases 2020; 8:4051-4058. [PMID: 33024762 PMCID: PMC7520784 DOI: 10.12998/wjcc.v8.i18.4051] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 06/23/2020] [Accepted: 08/12/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND As sudden sensorineural hearing loss (SSNHL) rarely occurs in pregnant women, there is a lack of knowledge and relevant research on its management.
AIM To investigate the effect of intratympanic dexamethasone injection in the treatment of pregnant patients with SSNHL.
METHODS A retrospective chart review was made for the period between June 2017 and August 2019 at our Department of Otorhinolaryngology-Head and Neck Surgery. Pregnant women who met the criteria for SSNHL were included and grouped based on the therapeutic modalities. The treatment group received intratympanic dexamethasone (2.5 mg) q.o.d. for a total of four times, while the control group received no medication other than bed rest and medical observations. All the patients were under close care of obstetricians. Pure-tone audiograms were performed before and after treatment.
RESULTS Eleven patients who met the inclusion criteria were assigned to the treatment group (n = 7) and the control group (n = 4). The mean age of patients was 31.2 ± 3.8 years; the right ear was affected in seven (63.64%) cases. Two patients (18.2%) suffered from vertigo, 10 (90.9%) suffered from tinnitus and 6 (54.5%) suffered from aural fullness. The time from onset to clinic visit was relatively short, with a mean time of 1.3 ± 0.9 d. All the women were within the second or third trimester; the average gestation period was 26.0 ± 6.2 wk. The pure-tone averages at onset between the two groups were similar. After one wk of therapy, the treatment group had a curative rate of 57.1% and a significantly better hearing threshold and greater improvement compared to the control group (all P < 0.05). Some patients experienced transient discomfort from intratympanic injections that disappeared after getting rest, while none had permanent complications. All patients delivered healthy full-term neonates with an average Apgar score of 9.7 ± 0.5.
CONCLUSION Intratympanic dexamethasone injections can be used as a first-line therapy in pregnant women with SSNHL.
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Affiliation(s)
- Yan-Lu Lyu
- Department of Otorhinolaryngology–Head and Neck Surgery, Shenzhen People’s Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen 518020, Guangdong Province, China
| | - Fan-Qian Zeng
- Department of Otorhinolaryngology–Head and Neck Surgery, Shenzhen People’s Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen 518020, Guangdong Province, China
| | - Zhou Zhou
- Department of Otorhinolaryngology–Head and Neck Surgery, Shenzhen People’s Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen 518020, Guangdong Province, China
| | - Min Yan
- Department of Otorhinolaryngology–Head and Neck Surgery, Shenzhen People’s Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen 518020, Guangdong Province, China
| | - Wei Zhang
- Department of Otorhinolaryngology–Head and Neck Surgery, Shenzhen People’s Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen 518020, Guangdong Province, China
| | - Ming Liu
- Department of Otorhinolaryngology–Head and Neck Surgery, Shenzhen People’s Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen 518020, Guangdong Province, China
| | - Zhao-Yang Ke
- Department of Otorhinolaryngology–Head and Neck Surgery, Shenzhen People’s Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen 518020, Guangdong Province, China
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