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, Table of Contents

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

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

› Author Affiliations

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

Full Text

References

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