Hearing loss in children exposed to toxoplasmosis during their gestation
Alterações auditivas em crianças expostas à toxoplasmose durante a gestação
Carlos Alberto Leite Filho; Lorena Carvalho Cavalcanti Lagreca; Natália Oliveira de Jesus; Cristiana Porchia Corvaro; Maria Aparecida Gadiani Ferrarini; Ana Isabel Melo Pereira Monteiro; Marisa Frasson de Azevedo
Abstract
Purpose: to verify the occurrence and the most frequent type of auditory disorders in children exposed to toxoplasmosis during pregnancy.
Methods: a retrospective, longitudinal study carried out in a public health institution of São Paulo. Records of children born between 2010 and 2015 were analyzed and distributed into two groups: study group, composed of 48 children born to mothers with a diagnosis of toxoplasmosis during their pregnancy; and control group, composed of 43 children without congenital infection, who were accompanied due to low birth weight. The children were evaluated two to four times during their first two years of life, by means of peripheral and central auditory function assessment.
Results: 47 children underwent only two evaluations and only 11 completed all the evaluations up to 24 months. In the control group, 58.1% had normal hearing, 37.2% conductive loss, 4.7% cochlear loss and absence of retrocochlear disorder. In the study group, 56.3% presented normal hearing, 20.8% conductive loss, 2.1% cochlear loss, and 20.8% retrocochlear disorder.
Conclusion: children exposed to toxoplasmosis during pregnancy did not differ from non-exposed children in relation to the occurrence of conductive or cochlear hearing loss. However, they showed a higher occurrence of retrocochlear disorder.
Keywords
Resumo
Objetivo: verificar a ocorrência e o tipo mais frequente de alteração auditiva em crianças expostas a toxoplasmose durante a gestação.
Métodos: estudo retrospectivo longitudinal realizado em instituição pública de saúde de São Paulo. Análise de prontuários de crianças nascidas entre 2010 e 2015 distribuídos em dois grupos: grupo estudo, composto por 48 crianças de mães com diagnóstico de toxoplasmose durante a gestação; e grupo controle, composto por 43 crianças sem infecção congênita que foram acompanhadas por apresentar baixo peso ao nascimento. As crianças foram avaliadas de duas a quatro vezes durante os dois primeiros anos de vida, por meio de testes que avaliam a função auditiva periférica e central.
Resultados: 47 crianças fizeram apenas duas avaliações e apenas 11 completaram todas as avaliações até 24 meses. No grupo controle 58,1% apresentaram audição normal, 37,2% perda condutiva, 4,7% perda coclear e ausência de alteração retrococlear, enquanto o grupo estudo apresentou 56,3% de audição normal, 20,8% de perda condutiva, 2,1% de perda coclear e 20,8% de alteração retrococlear.
Conclusão: crianças expostas à toxoplasmose durante a gestação não diferiram das não expostas em relação à ocorrência de perda auditiva coclear e condutiva. Entretanto, apresentaram maior ocorrência de alteração retrococlear.
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References
1. Sáfadi MAP, Farhat CK. Toxoplasmose. In: Farhat CK, Carvalho LHFR, Succi RCM. Infectologia pediátrica. 3a ed. São Paulo: Atheneu; 2008. p. 953-64.
2. Liesenfeld O. Toxoplasmose. In: Goldmann L, Ausiello D. Cecil Medicina. 23a ed. Rio de Janeiro: Elsevier; 2009. p. 2767-73.
3. Goulart AL, Santos AMN. Diagnóstico diferencial e tratamento das infecções congênitas. In: Morais MB, Campos SO, Hilário MOE (eds.). Pediatria Diagnóstico e Tratamento. 1a ed. Barueri: Manole; 2013. p. 209-19.
4. Andrade GMQ, Resende LM, Goulart EMA, Siqueira AL, Vitor RWA, Januario JN. Deficiência auditiva na toxoplasmose congênita detectada pela triagem neonatal. Rev Bras Otorrinolaringol. 2008;74(1):21-8.
5. Vasconcelos-Santos DV, Azevedo DOM, Campos WR, Oréfice F, Queiroz-Andrade GM, Carellos EVM et al. Congenital Toxoplasmosis Brazilian Group CTBG/UFMG. Congenital toxoplasmosis in southeastern Brazil: results of early ophthalmologic examination of a large cohort of neonates. Ophthalmology. 2009;116(11):2199-205.
6. Varella IS, Canti ICT, Santos BR, Coppini AZ, Argondizzo LC, Tonin C et al. Prevalence of acute toxoplasmosis infection among 41,112 pregnant women and the mother-to-child transmission rate in a public hospital in South Brazil. Mem Inst Oswaldo Cruz. 2009;104(2):383-8.
7. Jenum PA, Stray-Pedersen B, Melby KK, Kapperud G, Whitelaw A, Eskild A et al. Incidence of Toxoplasma gondii infection in 35,940 pregnant women in Norway and pregnancy outcome for infected women. J Clin Microbiol. 1998;36(10):2900-6.
8. Artigao FB, Martín FC, Corripio IF, Mellgren AG, Guasch CF, Miranda MCF et al. Guía de la Sociedad Española de Infectología Pediátrica para el diagnóstico y tratamiento de la toxoplasmosis congénita. Anales de Pediatría. 2013;79(2):116.e1-16.
9. Wright I. Congenital toxoplasmosis and deafness. An investigation. Pract Otorhinolaryngol (Basel). 1971;33(6):377-87.
10. Cecatto SB, Garcia RID, Costa KS, Abdo TRT, Rezende CEB, Rapoport PB. Análise das principais etiologias de deficiência auditiva em Escola Especial "Anne Sullivan". Rev Bras Otorrinolaringol. 2003;69(2):235-40.
11. Resende LM, Andrade GMQ, Azevedo MF, Perissinoto J, Vieira BC. Congenital Toxoplasmosis Brazilian Group CTBG/UFMG. Congenital toxoplasmosis: auditory and language outcomes in early diagnosed and treated children. Sci Med. 2010;20(1):13-9.
12. Remington JS, McLeod R, Thulliez P, Desmonts G. Toxoplasmosis. In: Remington JS, Klein JO, Wilson CB, Baker CJ (eds.). Infectious diseases of the fetus and newborn infant. 7th ed. Philadelphia: Elsevier Saunders; 2011. p.918-1041.
13. Wilson CB, Desmonts G, Couvreur J, Remington JS. Lymphocyte transformation in the diagnosis of congenital toxoplasma infection. N Engl J Med. 1980;302(14):785-8.
14. McLeod R, Boyer K, Karrison T, Kasza K, Swisher C, Roizen N et al. Toxoplasmosis Study Group. Outcome of treatment for congenital toxoplasmosis, 1981-2004: the National Collaborative Chicago-Based, Congenital Toxoplasmosis Study. Clin Infect Dis. 2006;42(10):1383-94.
15. Joint Committee on Infant Hearing. Year 2007 Position Statement: principles and guidelines for early hearing detection and intervention programs. Pediatrics. 2007;120(4):898-921.
16. Jesus NO, Angrisani RG, Maruta EC, Azevedo MF. Efeito de supressão nas emissões otoacústicas em lactentes termo e pré-termo. CoDAS. 2016;28(4):331-7.
17. Jerger J. Clinical experience with impedance audiometry. Arch Otolaryngol. 1970;92(4):311-24.
18. Northern JL, Downs MP. Audição na infância. 5a ed. Rio de Janeiro: Guanabara Koogan; 2005.
19. Gorga M, Kaminski J, Beauchaine K, Jesteadt W, Neely S. Auditory brainstem responses from children three months to three years of age: normal patterns of response II. J Speech Hear Res. 1989;32(2):281-8.
20. Stapells DR, Gravel JS, Martin BA. Thresholds for auditory brain stem responses to tones in notched noise from infants and young children with normal hearing or sensorineural hearing loss. Ear Hear. 1995;16(4):361-71.
21. Ho V, Daly KA, Hunter LL, Davey C. Otoacoustic emissions and tympanometry screening among 0-5 year olds. Laryngoscope. 2002;112(3):513-9.
22. Petit C. Genes Responsible for human hereditary deafness: symphony of a thousand. Nat Genetics. 1996;14(4):385-91.
23. Austeng ME, Eskila A, Jacobsen M, Jenum PA, Whitelaw A, Engdahl B. Maternal infection with Toxoplasma gondii in pregnancy and the risk of hearing loss in the offspring. Int J Audiol. 2010;49(1):65-8.
24. Salviz M, Monctoya JG, Nadol JB, Santos F. Otopathology in congenital toxoplasmosis. Otol Neurotol. 2013;34(6):1165-9.
25. Noorbakhsh S, Memari F, Farhadi M, Tabatabaei A. Sensorineural hearing loss due to Toxoplasma gondii in children: a case-control study. Clin Otolaryngol. 2008;33(3):269-73.
26. McGee T, Wolters C, Stein L, Kraus N, Johnson D, Boyer K et al. Absence of sensorineural hearing loss in treated infants and children with congenital toxoplasmosis. Otolaryngol Head and Neck Surg. 1992;106(1):75-80.
27. Muhaimeed HA. Prevalence of sensorineural hearing loss due to toxoplasmosis in Saudi children: a hospital based study. Int J Pediatr Otolaryngol. 1996;34(1-2):1-8.
28. Brown ED, Chau JK, Atashband S, Westerberg B, Kozak FK. A systematic review of neonatal toxoplasmosis exposure and sensorineural hearing loss. Int J Pediatr Otorhinolaryngol. 2009;73(5):707-11.
Submitted date:
10/02/2016
Accepted date:
05/30/2017
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