Hearing impairment Linked To Worse Pregnancy, Birth Outcomes

Deaf and hard of hearing (DHH) women have more pregnancy complications and worse birth outcomes than their peers without hearing impairment, according to a new study.

"After adjusting for demographics, DHH women were at an increased risk of chronic conditions, pregnancy complications, and specific adverse birth outcomes including preterm birth and very low birth weight," Dr. Monika Mitra of Brandeis University in Waltham, Massachusetts, and colleagues write in the American Journal of Preventive Medicine.

Hearing loss is reported by about 4.7% of reproductive-age women in the US, Dr. Mitra and her team note. While their own research suggested an increased risk of adverse pregnancy and birth outcomes in DHH women, they add, a study by another team found similar outcomes for women with and without hearing impairment.

Using the Massachusetts Pregnancy to Early Life Longitudinal data set, which includes all birth certificates, fetal death reports and hospital discharge records for babies born in the state and their mothers, the authors identified 1.19 million singleton deliveries in 1998-2013, including 1,385 to DHH women.

DHH women were more likely than those without hearing impairment to be black, have completed fewer years of school, to be born in the US, and to have smoked while pregnant. Several chronic medical conditions were more common among the DHH women, including pre-existing diabetes, hypertension, gestational diabetes, and pre-eclampsia and eclampsia. They were also more likely to deliver by cesarean section and to spend more than 4 days in the hospital after delivering vaginally.

Preterm birth occurred in 9.2% of deliveries to DHH women and 7.1% of non-DHH women (P < 0.01), and 7.2% of infants born to DHH women were low birth weight versus 5.6% of infants whose mothers did not have hearing loss (P < 0.05).

Very low weight, small for gestational age and low Apgar scores were also significantly more common in infants born to DHH women.

Several factors could account for the worse pregnancy and birth outcomes for DHH women, the authors note, including communication difficulties, genetics and illnesses that occur more often in people with hearing loss. People with DHH are also more prone to stress, depression, anxiety and interpersonal violence, they add, all of which can increase the risk of poor pregnancy outcomes.

The results "underscore the need for a systematic investigation of the pregnancy- and neonatal-related risks, complications, costs, mechanisms, and outcomes of DHH women," the authors write.

"Additional research is also needed to understand the experiences of DHH women during pregnancy, childbirth, and postpartum and to develop effective and evidence-based clinical and policy interventions to improve these outcomes," they conclude.



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