Geographic and Racial Disparities in Infant Hearing Loss. (9th October 2018)

• Record Type: Journal Article
• Authors: Lantos, Paul M.; Maradiaga‐Panayotti, Gabriela; Barber, Xavier; Raynor, Eileen; Tucci, Debara; Hoffman, Kate; Permar, Sallie R.; Jackson, Pearce; Hughes, Brenna L.; Kind, Amy; Swamy, Geeta K.
• Is Part Of: Otolaryngology--head and neck surgery. Volume 159:Number 6(2018)
• Page Start: 1051
• Page End: 1057
• Publication Date: 2018-10-09
• Subjects: newborn -- hearing screening -- hearing loss -- congenital cytomegalovirus -- cytomegalovirus -- geographic information systems -- epidemiology -- spatial epidemiology -- map -- geography -- disparities; Head -- Surgery -- Periodicals; Neck -- Surgery -- Periodicals; Otolaryngology -- Periodicals; 617.51
• DOI: 10.1177/0194599818803305
• Languages: English
• ISSNs: 0194-5998

Abstract

Abstract : Objective: Approximately 1 to 2 of every 1000 American newborns has hearing loss identified by newborn screening. This study was designed to determine if infant hearing loss is more common in socioeconomically disadvantaged communities. Study Design: In this retrospective study, we analyzed electronic medical record data using geostatistical models. Setting: Infants were residents of Durham County, North Carolina, born in 2 hospitals of the Duke University Health System. This county includes the city of Durham and surrounding suburban and rural communities. Subjects and Methods: Subjects were hearing‐screened newborns, born between 2005 and 2016, whose residential address was in Durham County, North Carolina. This was a retrospective study using medical record data. We used Bayesian regression models with smoothing of coordinate date to identify both spatial and nonspatial predictors of infant hearing loss. Results: We identified 19, 348 infants from Durham County, of whom 675 had failed initial hearing screening and 191 had hearing loss confirmed on follow‐up. Hearing loss was significantly associated with minority race (odds ratio [OR], 2.45; 95% confidence interval, 1.97‐3.06), as well as lower gestational age and maternal sexually transmitted infections. We identified significant geographic heterogeneity, with a higher probability of hearing loss in poorer urban neighborhoods (local OR range, 0.59‐1.39). Neighborhood disadvantage was a significant predictor of hearing loss, as was high local seroprevalence of cytomegalovirus (CMV) among pregnant women. Conclusions: Urban, low‐income neighborhoods have a high prevalence of infant hearing loss compared with more affluent surrounding communities, particularly among minorities. This distribution may be attributable to congenital CMV infection.