The Association between Prenatal Nicotine Exposure and Offspring's Hearing Impairment

Erin M. Cleary; Douglas A. Kniss; Lida M. Fette; Brenna L. Hughes; George R. Saade; Mara J. Dinsmoor; Uma M. Reddy; Cynthia Gyamfi-Bannerman; Michael W. Varner; William H. Goodnight; Alan T. N. Tita; Geeta K. Swamy; Kent D. Heyborne; Edward K. Chien; Suneet P. Chauhan; Yasser Y. El-Sayed; Brian M. Casey; Samuel Parry; Hyagriv N. Simhan; Peter G. Napolitano; for the Eunice Kennedy Shriver National Institute of Child Health Human Development Maternal-Fetal Medicine Units (MFMU) Network

doi:10.1055/s-0042-1750407

American Journal of Perinatology, Inhaltsverzeichnis

Am J Perinatol 2024; 41(S 01): e119-e125
DOI: 10.1055/s-0042-1750407

Original Article

The Association between Prenatal Nicotine Exposure and Offspring's Hearing Impairment

Authors

Erin M. Cleary

¹Department of Obstetrics and Gynecology, The Ohio State University, Columbus, Ohio
Douglas A. Kniss

¹Department of Obstetrics and Gynecology, The Ohio State University, Columbus, Ohio
Lida M. Fette

²George Washington University Biostatistics Center, Washington, District of Columbia
Brenna L. Hughes

³Brown University, Providence, Rhode Island
George R. Saade

⁴University of Texas Medical Branch, Galveston, Texas
Mara J. Dinsmoor

⁵Northwestern University, Chicago, Illinois
Uma M. Reddy

⁶the Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland
Cynthia Gyamfi-Bannerman

⁷Columbia University, New York, New York
Michael W. Varner

⁸University of Utah Health Sciences Center, Salt Lake City, Utah
William H. Goodnight

⁹University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
Alan T. N. Tita

¹⁰University of Alabama at Birmingham, Birmingham, Alabama
Geeta K. Swamy

¹¹Duke University, Durham, North Carolina
Kent D. Heyborne

¹²University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, Colorado
Edward K. Chien

¹³Case Western Reserve University, Cleveland, Ohio
Suneet P. Chauhan

¹⁴University of Texas Health Science Center at Houston, Children's Memorial Hermann Hospital, Houston, Texas
Yasser Y. El-Sayed

¹⁵Stanford University, Stanford, California
Brian M. Casey

¹⁶University of Texas Southwestern Medical Center, Dallas, Texas
Samuel Parry

¹⁷University of Pennsylvania, Philadelphia, Pennsylvania
Hyagriv N. Simhan

¹⁸Department of Obstetrics, Gynecology and Reproductive SciencesUniversity of Pittsburgh, Pittsburgh, Pennsylvania
Peter G. Napolitano

¹⁹Madigan Army Medical Center, Joint Base Lewis-McChord, Washington, District of Columbia

for the Eunice Kennedy Shriver National Institute of Child Health Human Development Maternal-Fetal Medicine Units (MFMU) Network

Abstract

Objectives The objective of this study is to evaluate whether there is an association between in-utero exposure to nicotine and subsequent hearing dysfunction.

Materials and Methods Secondary analysis of a multicenter randomized trial to prevent congenital cytomegalovirus (CMV) infection among gravidas with primary CMV infection was conducted. Monthly intravenous immunoglobulin hyperimmune globulin therapy did not influence the rate of congenital CMV. Dyads with missing urine, fetal or neonatal demise, infants diagnosed with a major congenital anomaly, congenital CMV infection, or with evidence of middle ear dysfunction were excluded. The primary outcome was neonatal hearing impairment in one or more ears defined as abnormal distortion product otoacoustic emissions (DPOAEs; 1 to 8 kHz) that were measured within 42 days of birth. DPOAEs were interpreted using optimized frequency-specific level criteria. Cotinine was measured via enzyme-linked immunosorbent assay kits in maternal urine collected at enrollment and in the third trimester (mean gestational age 16.0 and 36.7 weeks, respectively). Blinded personnel ran samples in duplicates. Maternal urine cotinine >5 ng/mL at either time point was defined as in-utero exposure to nicotine. Multivariable logistic regression included variables associated with the primary outcome and with the exposure (p < 0.05) in univariate analysis.

Results Of 399 enrolled patients in the original trial, 150 were included in this analysis, of whom 46 (31%) were exposed to nicotine. The primary outcome occurred in 18 (12%) newborns and was higher in nicotine-exposed infants compared with those nonexposed (15.2 vs. 10.6%, odds ratio [OR] 1.52, 95% confidence interval [CI] 0.55–4.20), but the difference was not significantly different (adjusted odds ratio [aOR] = 1.0, 95% CI 0.30–3.31). This association was similar when exposure was stratified as heavy (>100 ng/mL, aOR 0.72, 95% CI 0.15–3.51) or mild (5–100 ng/mL, aOR 1.28, 95% CI 0.33–4.95). There was no association between nicotine exposure and frequency-specific DPOAE amplitude.

Conclusion In a cohort of parturients with primary CMV infection, nicotine exposure was not associated with offspring hearing dysfunction assessed with DPOAEs.

Key Points

Nicotine exposure was quantified from maternal urine.
Nicotine exposure was identified in 30% of the cohort.
Exposure was not associated with offspring hearing dysfunction.

Keywords

neonatal hearing impairment - prenatal nicotine exposure - newborn hearing screening

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Referenzen

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