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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

Erin M. Cleary 
1   Department of Obstetrics and Gynecology, The Ohio State University, Columbus, Ohio
,
Douglas A. Kniss
1   Department of Obstetrics and Gynecology, The Ohio State University, Columbus, Ohio
,
Lida M. Fette
2   George Washington University Biostatistics Center, Washington, District of Columbia
,
Brenna L. Hughes
3   Brown University, Providence, Rhode Island
,
George R. Saade
4   University of Texas Medical Branch, Galveston, Texas
,
Mara J. Dinsmoor 
5   Northwestern University, Chicago, Illinois
,
Uma M. Reddy
6   the Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland
,
Cynthia Gyamfi-Bannerman
7   Columbia University, New York, New York
,
Michael W. Varner 
8   University of Utah Health Sciences Center, Salt Lake City, Utah
,
William H. Goodnight
9   University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
,
Alan T. N. Tita
10   University of Alabama at Birmingham, Birmingham, Alabama
,
Geeta K. Swamy
11   Duke University, Durham, North Carolina
,
Kent D. Heyborne
12   University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, Colorado
,
Edward K. Chien
13   Case Western Reserve University, Cleveland, Ohio
,
Suneet P. Chauhan
14   University of Texas Health Science Center at Houston, Children's Memorial Hermann Hospital, Houston, Texas
,
Yasser Y. El-Sayed
15   Stanford University, Stanford, California
,
Brian M. Casey
16   University of Texas Southwestern Medical Center, Dallas, Texas
,
Samuel Parry
17   University of Pennsylvania, Philadelphia, Pennsylvania
,
Hyagriv N. Simhan
18   Department of Obstetrics, Gynecology and Reproductive SciencesUniversity of Pittsburgh, Pittsburgh, Pennsylvania
,
Peter G. Napolitano
19   Madigan 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 › Institutsangaben Funding This work was supported by grants (HD40500, HD36801, HD53097, HD40512, HD40485, HD34208, HD40560, HD27869, HD27915, HD68258, HD68282, HD40544, HD40545, HD68268, HD34116, HD87192, and HD87230) from the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) and the National Center for Advancing Translational Sciences (UL1TR001873 and UL1TR000040). Both Cytogam and AlbuRx were provided by CSL Behring, Inc., free of charge. The company had no involvement in the data management, analysis, or preparation of this manuscript. The views expressed are those of the author(s) and do not represent the official views of or the official policy of the National Institutes of Health, the Department of the Army, the Department of Defense, or the U.S. Government. The investigators have adhered to the policies for the protection of human subjects as prescribed in 45 CFR 46.
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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

Note

Presented at the 41st Annual Meeting of the Society for Maternal Fetal Medicine 2021.


* The other members of the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) Maternal-Fetal Medicine Units Network are listed in the Appendix.




Publikationsverlauf

Eingereicht: 13. April 2022

Angenommen: 20. April 2022

Artikel online veröffentlicht:
25. August 2022

© 2022. Thieme. All rights reserved.

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 

  • References

  • 1 Thompson DC, McPhillips H, Davis RL, Lieu TL, Homer CJ, Helfand M. Universal newborn hearing screening: summary of evidence. JAMA 2001; 286 (16) 2000-2010
    CrossrefPubMedGoogle Scholar
  • 2 Mohr PE, Feldman JJ, Dunbar JL. et al. The societal costs of severe to profound hearing loss in the United States. Int J Technol Assess Health Care 2000; 16 (04) 1120-1135
    CrossrefPubMedGoogle Scholar
  • 3 Mai CT, Isenburg JL, Canfield MA. et al; National Birth Defects Prevention Network. National population-based estimates for major birth defects, 2010-2014. Birth Defects Res 2019; 111 (18) 1420-1435
    CrossrefPubMedGoogle Scholar
  • 4 Smith RJH, Bale Jr JF, White KR. Sensorineural hearing loss in children. Lancet 2005; 365 (9462): 879-890
    CrossrefPubMedGoogle Scholar
  • 5 Goderis J, De Leenheer E, Smets K, Van Hoecke H, Keymeulen A, Dhooge I. Hearing loss and congenital CMV infection: a systematic review. Pediatrics 2014; 134 (05) 972-982
    CrossrefPubMedGoogle Scholar
  • 6 Wilunda C, Yoshida S, Tanaka S, Kanazawa Y, Kimura T, Kawakami K. Exposure to tobacco smoke prenatally and during infancy and risk of hearing impairment among children in Japan: a retrospective cohort study. Paediatr Perinat Epidemiol 2018; 32 (05) 430-438
    CrossrefPubMedGoogle Scholar
  • 7 Weitzman M, Govil N, Liu YH, Lalwani AK. Maternal prenatal smoking and hearing loss among adolescents. JAMA Otolaryngol Head Neck Surg 2013; 139 (07) 669-677
    PubMedGoogle Scholar
  • 8 Dhar S, Hall IJW. Otoacoustic Emissions: Principles, Procedures, and Protocols. Second. In: Brad A, Stach P. ed. Plural Publishing Inc;; 2018
    Google Scholar
  • 9 Lambers DS, Clark KE. The maternal and fetal physiologic effects of nicotine. Semin Perinatol 1996; 20 (02) 115-126
    CrossrefPubMedGoogle Scholar
  • 10 Durante AS, Ibidi SM, Lotufo JPB, Carvallo RMM. Maternal smoking during pregnancy: impact on otoacoustic emissions in neonates. Int J Pediatr Otorhinolaryngol 2011; 75 (09) 1093-1098
    CrossrefPubMedGoogle Scholar
  • 11 Korres S, Riga M, Balatsouras D, Papadakis C, Kanellos P, Ferekidis E. Influence of smoking on developing cochlea. Does smoking during pregnancy affect the amplitudes of transient evoked otoacoustic emissions in newborns?. Int J Pediatr Otorhinolaryngol 2007; 71 (05) 781-786
    PubMedGoogle Scholar
  • 12 Key APF, Ferguson M, Molfese DL, Peach K, Lehman C, Molfese VJ. Smoking during pregnancy affects speech-processing ability in newborn infants. Environ Health Perspect 2007; 115 (04) 623-629
    CrossrefPubMedGoogle Scholar
  • 13 King E, Campbell A, Belger A, Grewen K. Prenatal nicotine exposure disrupts infant neural markers of orienting. Nicotine Tob Res 2018; 20 (07) 897-902
    CrossrefPubMedGoogle Scholar
  • 14 Hughes BL, Clifton RG, Rouse DJ. et al; Eunice Kennedy Shriver National Institute of Child Health and Human Development Maternal–Fetal Medicine Units Network. A trial of hyperimmune globulin to prevent congenital cytomegalovirus infection. N Engl J Med 2021; 385 (05) 436-444
    CrossrefPubMedGoogle Scholar
  • 15 Blankenship CM, Hunter LL, Keefe DH. et al. Optimizing clinical interpretation of distortion product otoacoustic emissions in infants. Ear Hear 2018; 39 (06) 1075-1090
    CrossrefPubMedGoogle Scholar
  • 16 Dhar P. Measuring tobacco smoke exposure: quantifying nicotine/cotinine concentration in biological samples by colorimetry, chromatography and immunoassay methods. J Pharm Biomed Anal 2004; 35 (01) 155-168
    CrossrefPubMedGoogle Scholar
  • 17 Etzel RA. A review of the use of saliva cotinine as a marker of tobacco smoke exposure. Prev Med 1990; 19 (02) 190-197
    CrossrefPubMedGoogle Scholar
  • 18 Balhara YPS, Jain R. A receiver operated curve-based evaluation of change in sensitivity and specificity of cotinine urinalysis for detecting active tobacco use. J Cancer Res Ther 2013; 9 (01) 84-89
    CrossrefPubMedGoogle Scholar
  • 19 Blanchet C, Eróstegui C, Sugasawa M, Dulon D. Acetylcholine-induced potassium current of guinea pig outer hair cells: its dependence on a calcium influx through nicotinic-like receptors. J Neurosci 1996; 16 (08) 2574-2584
    CrossrefPubMedGoogle Scholar
  • 20 Browning GG, Gatehouse S, Lowe GDO. Blood viscosity as a factor in sensorineural hearing impairment. Lancet 1986; 1 (8473): 121-123
    CrossrefPubMedGoogle Scholar
  • 21 Fechter LD, Thorne PR, Nuttall AL. Effects of carbon monoxide on cochlear electrophysiology and blood flow. Hear Res 1987; 27 (01) 37-45
    CrossrefPubMedGoogle Scholar
  • 22 Nelson HD, Bougatsos C, Nygren P. 2001 US Preventive Services Task Force. Universal newborn hearing screening: systematic review to update the 2001 US Preventive Services Task Force Recommendation. Pediatrics 2008; 122 (01) e266-e276
    CrossrefPubMedGoogle Scholar
  • 23 Kemper AR, Downs SM. A cost-effectiveness analysis of newborn hearing screening strategies. Arch Pediatr Adolesc Med 2000; 154 (05) 484-488
    CrossrefPubMedGoogle Scholar
  • 24 Hamilton ST, Scott G, Naing Z. et al. Human cytomegalovirus-induces cytokine changes in the placenta with implications for adverse pregnancy outcomes. PLoS One 2012; 7 (12) e52899
    CrossrefPubMedGoogle Scholar