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

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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.

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