Is antenatal corticosteroids exposure associated with hearing loss in preterm infants? A systematic review and meta-analysis

Purpose: To perform a systematic review and meta-analysis of clinical studies exploring the association between antenatal corticosteroids exposure and hearing loss in preterm infants.

Method: PubMed, Cochrane library, and EMBASE databases from the inception dates to December 22, 2020 without language restriction. Key search terms included hearing loss, cortisol steroid, and antenatal. Included studies were case control or cohort studies examining preterm (<37 weeks' gestation) or very low-birth-weight (<1500 g) infants and reporting primary data that could be used to explore the association between antenatal corticosteroids exposure and the development of hearing outcomes. This meta-analysis follows the reporting guidelines (MOOSE) for observational studies. Data were independently extracted by 2 researchers. A fixed effects model was used to calculate odds ratios (OR) and 95 % CI. Subgroup analysis was conducted according to different types of antenatal steroids exposure (dexamethasone vs betamethasone) and subgroup analyses based on betamethasone and betamethasone combined with magnesium sulfate (betamethasone vs betamethasone combined with magnesium sulfate).

Results: A total of 110 potentially relevant studies were found, of which 7 met the inclusion criteria (A total of 8130 preterm infants were included. 5337 preterm infants were exposed to antenatal corticosteroids, and 2793 preterm infants were not exposed to antenatal corticosteroids.). Meta-analysis showed that antenatal corticosteroids exposure was significantly associated with hearing loss in preterm infants. (OR, 0.64; 95 % CI, 0.48-0.87; P = 0.004) In addition, significant differences were found between antenatal betamethasone exposure and antenatal dexamethasone exposure. (OR, 0.27; 95 % CI, 0.10-0.77; P = 0.01) Betamethasone and betamethasone combined with magnesium sulfate showed that the difference was no statistically significant. (OR, 1.34; 95 % CI, 0.74-2.43; P = 0.33).

Conclusion: The results of this study confirm that among preterm infants, exposure to antenatal corticosteroids exposure is associated with a lower risk of developing hearing impairment.

Systematic review registration number: PROSPERO 2021 CRD42021255665.