Sensorineural hearing loss in children: The association with Apgar score. A registry-based study of 392 371 children in Norway

Objectives: The causes of congenital permanent hearing loss in children are insufficiently understood. We studied the association of Apgar score 5 mm after birth with sensorineural hearing loss diagnosed before the age of 5 years. Methods: We performed an epidemiological cohort study with data obtained by linkage between The Medical Birth Registry of Norway and the Norwegian County Registry of Children with Hearing Loss. Cases were 327 children born in Norway during the period 1978-1998 with sensorineural hearing loss. Controls were all children in Norway without sensorineural hearing loss born in the same counties and during the same period as the cases (n = 392 044). The associations of Apgar score 5 mm after birth with sensorineural hearing loss were estimated as odds ratios (OR) with 95% confidence intervals (CI) by applying logistic regression analyses. Results: Among children with sensorineural hearing loss 0.9% (3/327) had Apgar score <3, whereas that was true for 0.1% (304/392 044) of children without hearing loss (p = 0.001, chi square test). The aOR for sensorineural hearing loss was 7.5 [95% CI 2.3-, 24.2] comparing Apgar score <3 to Apgar score 10, after adjustment for birthweight and concurrent birth defects. Most children with sensorineural hearing loss (90%) had Apgar score >8 five minutes after birth. Conclusions: Low Apgar score was associated with childhood sensorineural hearing loss. However, most children with sensorineural hearing loss, had Apgar score >8. (C) 2014 Elsevier Ireland Ltd. All rights reserved.