Neonatal hearing screening of newborns of mothers with Diabetic Mellitus and/or hypertension in pregnancy: a systematic literature review

Vernier, Luíza Silva; Castelli, Carla Thamires Rodriguez; Levandowski, Daniela Centenaro

doi:10.1590/1982-0216/201921313717

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REVIEW ARTICLES • Rev. CEFAC 21 (3) • 2019 • https://doi.org/10.1590/1982-0216/201921313717 copy

Neonatal hearing screening of newborns of mothers with Diabetic Mellitus and/or hypertension in pregnancy: a systematic literature review

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Purpose:

to investigate the results of the Neonatal Hearing Screening (NHS) in neonates whose mothers presented hypertension and/or diabetes mellitus in their pregnancy.

Methods:

a systematic review of the literature, without restriction of year and language, guided by the PRISMA protocol, that was carried out through a search in the MEDLINE (PUBMED), LILACS (BVS), SCOPUS, WEB OF SCIENCE and EMBASE databases, using neonatal screening AND hearing AND (hypertension OR diabetes mellitus) as descriptors. Studies that were duplicated or were unavailable were excluded.

Results:

64 records were found, 5 being included for analysis. These articles had been published in the last 13 years, originated from different countries, and using a retrospective (cross-sectional, n=1, case-control, n=1) or prospective design (cross-sectional, n=1, case-control, n=1; cohort, n=1). The findings of the articles demonstrated differences regarding the presence of changes in the NHS outcomes of newborns whose mothers presented hypertension and/or diabetes during pregnancy.

Conclusion:

since the review showed contradictory results regarding changes in the NHS outcomes in the presence of mothers’ hypertension and/or diabetes during pregnancy, prospective cohort studies are needed, in different contexts, in order to isolate confounding factors for hearing loss and minimize measurement bias and selection.

Keywords:
Neonatal Screening; Hearing; Hypertension; Diabetes Mellitus; Review

Publication Year	Journal	Country	Purpose	Design	Sample	Gestational Disease	Technique/ Intervention (NHS) andage of the evaluated newborns	Results
1. 2014¹⁷17. Sequi-Canet JM, Sala-Langa MJ, Catillo JIC. Factores perinatales que in?uyen em La detección de otoemisiones acústicas em recién nacidos sanos, por parto vaginal, em lãs primeras 48 horas de vida. Acta Otorrinolaringol Esp. 2014;65(1):7.	Acta Otorrinolaringológica Española	Spain	To know the influence of diverse perinatal factors in response to the EOEs on the first 48h of life.	Retrospective Transversal	n total: 8.239 n diabetes: 162 n hypertension:77	Diabetes Mellitus Hypertension	The EOE type was not specified Made around the first 48 hours of the newborn’s life	Diabetes: p<0,98 Hypertension: p<0,32 No significant relation between diabetes or hypertension and the EOE.
2. 2014¹⁸18. Ulanovsky I, Diab K, Makhoul IR, Blazer S, Smolkin T. The effect of maternal medications, hypertension/pre-eclamptic toxemia and diabetes mellitus on neonatal hearing screening. Harefuah. 2014;153(9):511-4.	Harefuah	Israel	To verify the effect of medicaments and maternal diseases during pregnancy over the results of the first EOE tests.	Prospective Transversal	n total: 2306	Diabetes Mellitus Hypertension	The EOE type was not specified Made between 12 and over 48 hours of the newborn’s life	Diabetes and vaginal delivery: [OR 2.2 (1.0-4.84) p=0.049] Hypertension/preeclampsia and cesarean section: [OR 2.3 (1.22-4.3) p=0.01] There was significant relation between diabetes or hypertension and EOE failings
3. 2008⁹9. Bakhshaee M, Boskabadi H, Hassanzadeh M, Nourizadeh N, Ghassemi MM, Khazaeni K, et al. Hearing impairment in the neonate of preeclamptic women. Otolaryngol Head Neck Surg.2008;139(6):846-9.	Otolaryngology - Head and Neck Surgery	Iran	To determine the probable prevalence of hearing deficiency of children whose mothers had induced hypertension during pregnancy, in comparison to those born from healthy mothers.	Prospective Cohort	n total: 150 n hypertension: 36 n healthy: 114	Hypertension	TEOAE Made after birth. In case of failure, made again two weeks after birth. BAEP Made after failure in the second TEOAE test, until the end of the newborn’s first month of life.	FirstTEOAE: (p= 0.001) Second TEOAE: (p= 0.646) BAEP: (p= 0.573) This study suggests that preeclampsia might have some temporary effect over the hearing of newborns.
4. 2005¹⁰10. Stanton SG, Ryerson E, Moore SL, Sullivan-Mahoney M, Couch SC. Hearing screening outcomes in infants of pregestational diabetic mothers. Am J Audiol. 2005;14(1):86-93.	American Journal of Audiology	USA	To compare the NHS results of newborns whose mothers had pre-gestational diabetes with non-diabetic mothers.	Retrospective Case-control	n total: 146 n diabetes: 73 n healthy: 73	Diabetes Mellitus	DPOAE BAEP-A Doesn’t specify the lifetime used of the NHS realization - according to protocol	DPOAE: 5,5% (4/73) for the babies of the control groups (non-diabetic), and 11,0% (8/73) for infants of diabetic mothers. There was no significant relation for the failing, after the comparison of the groups(x2 = 0.82, p = 0.37). BAEP-A: 9,1% (1/11) for the group of diabetic patients in comparison to 0% (0/4) for the control groups. Despite not displaying the p value, the article explains that there was no significant relation.
5. 2002¹⁹19. Kountakis SE, Skoulas I, Phillips D, Chang CJ. Risk factors for hearing loss in neonates: a prospective study. Am J Otolaryngol.2002;23(3):133-7.	American Journal of Audiology	USA	To identify potential risk factors for newborn hearing loss that is not included in the variables recognized by the JCIH.	Prospective Case-control	n total: 746 n cases: 110 n controls: 636	Diabetes Mellitus	BAEP Doesn’t specify the lifetime used of NHS realization - according to protocol	Diabetes: (p=0.011) There was significant relation between the presence of maternal diabetes and newborn BAEP failure.

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[1] Corresponding address: Luíza Silva Vernier, RuaBarbedo, 448/702, Menino Deus, Zip Code: 90110-260 - Porto Alegre, Rio Grande do Sul, Brasil, E-mail: luiza.vernier@hotmail.com