Author(s)
Zaroug Jaleel, BS
Rita Y. Wang, BS
Michelle C. Hsu, MS
Richard Hubbell, MD
Jessica R. Levi, MD
Affiliation(s)
Boston University School of Medicine; Boston University School of Public Health; Boston Medical Center
Abstract:
Objective: Prematurity, defined by gestational age (GA) <37 weeks, is a risk factor for poor neonatal and early childhood
outcomes. An understudied sequela of prematurity is its possible association with otologic pathology. This study explores
the relationship between prematurity and otologic diagnoses, particularly characterizing hearing loss in prematurely-born
children.
Study Design: Retrospective Case-control study
Setting: Tertiary referral center
Patients: Pediatric patients aged 0-18 presenting to an otolaryngology clinic with a primary otologic diagnosis. (i.e
Sensorineural hearing loss (SNHL), Conductive Hearing Loss (CHL), Otitis Media, Eustachian tube dysfunction (ETD))
Interventions: Patients were retrospectively divided into four GA categories (<28 weeks, 28-32 weeks, 32-37 weeks, ≥37
weeks)
Main Outcome Measures: Adjusted odds ratio (aOR) of GA and associated otologic conditions.
Results: Adjusting for covariates, patients with low GA (<37 weeks) were significantly more likely to be diagnosed with
CHL when compared to full-term children (≥37 weeks) (p<0.05). This result held across all GA categories with <28 weeks
(aOR [95% CI]) (4.26 [1.55-11.719]), 28-32 weeks (4.31 [2.12-8.79]), and 32-37 weeks (1.50 [1.02-2.19]). Prematurity was
overall also associated with ETD compared to full-term children (p<0.05) with ≥28 to <32 weeks (2.53 [1.48-4.32]) and
≥32 to <37 weeks (1.55 [1.18-2.03]). Prematurity was not significantly associated with SNHL, Otitis Media or a failed
hearing screen.
Conclusions: Prematurity was associated with a higher rate of CHL and ETD diagnosis with no significant difference in
SNHL diagnosis when compared to presenting full-term children. The results support an association between prematurity
and otologic pathology.
REQUIRED:
Define Professional Practice Gap & Educational Need: Currently there is little research into the role prematurity plays
in otologic pathology in pediatric patients. This is one of the first comprehensive studies looking at the association between
low gestational age and common otologic diagnosis in pediatric patients.
Learning Objective: Understand prematurity as an independent risk factor for otologic pathology in pediatric patients with
an increased rate of conductive hearing loss.
Desired Result: By the end of this lecture attendees should be able to discuss the otologic complications of prematurity
Level of Evidence – Level 3
Indicate IRB or IACUC: : Exempt by Boston Medical Center IRB (H-37753).