Ear Abnormalities Among Children with Fetal Alcohol Spectrum Disorder: A Systematic Review and Meta-Analysis

Melissa Mei Yin Cheung; Tracey W Tsang; Rochelle Watkins; Catherine Birman; Svetlana Popova; Elizabeth J Elliott

doi:10.1016/j.jpeds.2021.11.016

Ear Abnormalities Among Children with Fetal Alcohol Spectrum Disorder: A Systematic Review and Meta-Analysis

J Pediatr. 2022 Mar:242:113-120.e16. doi: 10.1016/j.jpeds.2021.11.016. Epub 2021 Nov 13.

Authors

Melissa Mei Yin Cheung¹, Tracey W Tsang², Rochelle Watkins³, Catherine Birman⁴, Svetlana Popova⁵, Elizabeth J Elliott⁶

Affiliations

¹ The University of Sydney Children's Hospital Westmead Clinical School, Discipline of Child and Adolescent Health, Faculty of Medicine and Health, The University of Sydney, Westmead, Australia; Australian Pediatric Surveillance Unit, Kids Research, Sydney Children Hospitals Network, Westmead, Australia. Electronic address: melissa.cheung@sydney.edu.au.
² The University of Sydney Children's Hospital Westmead Clinical School, Discipline of Child and Adolescent Health, Faculty of Medicine and Health, The University of Sydney, Westmead, Australia.
³ Telethon Kids Institute, Perth Children's Hospital, Perth, Australia.
⁴ The University of Sydney Children's Hospital Westmead Clinical School, Discipline of Child and Adolescent Health, Faculty of Medicine and Health, The University of Sydney, Westmead, Australia; Faculty of Medicine, Health and Human Sciences, Macquarie University, North Ryde, Australia.
⁵ Center for Addiction and Mental Health, Toronto, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.
⁶ The University of Sydney Children's Hospital Westmead Clinical School, Discipline of Child and Adolescent Health, Faculty of Medicine and Health, The University of Sydney, Westmead, Australia; Australian Pediatric Surveillance Unit, Kids Research, Sydney Children Hospitals Network, Westmead, Australia.

PMID: 34780779
DOI: 10.1016/j.jpeds.2021.11.016

Abstract

Objective: To systematically review and conduct meta-analysis on studies that report the type and prevalence of functional and structural ear abnormalities among children with prenatal alcohol exposure and/or fetal alcohol spectrum disorder (FASD).

Study design: MEDLINE, PubMed, Embase, Web of Science, PsycINFO, ERIC, CINAHL, and Maternity and Infant Care were searched from 1806 through March 2021. Reference lists of relevant articles were manually searched. Studies reporting on functional and/or structural ear abnormalities among children (<18 years) with prenatal alcohol exposure and/or FASD were eligible. Data extraction and quality assessment were performed by one reviewer and independently checked by another. A random effects meta-analysis was conducted.

Results: A total of 31 studies met the inclusion criteria and 25 were included in the meta-analyses, representing a total of 843 children with prenatal alcohol exposure and 1653 children with FASD. Functional ear abnormalities with the highest pooled prevalence were chronic serous otitis media (88.5%; 95% CI, 70.4%-99.3%), abnormal auditory filtering (80.1%; 95% CI, 76.5%-84.3%), and unspecified conductive hearing loss (68.0%; 95% CI, 51.9%-82.2%). Structural ear abnormalities with the highest pooled prevalence were microtia (42.9%; 95% CI, 26.8%-59.7%), railroad track ear (16.8%; 95% CI, 8.1%-27.7%), and misplaced ear (12.3%; 95% CI, 7.6%-17.9%).

Conclusions: Our findings highlight the importance of examining the ears during assessment for FASD, and the need for public health messaging regarding the harms of prenatal alcohol exposure.

Publication types

Meta-Analysis
Systematic Review

MeSH terms

Child
Female
Fetal Alcohol Spectrum Disorders* / epidemiology
Humans
Infant
Otitis Media with Effusion*
Pregnancy
Prenatal Exposure Delayed Effects*
Prevalence