Maternal Exposure to Medications and the Risk of Congenital and Early-Onset Hearing Loss in Children: A Systematic Review and a Meta-Analysis.

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.