January 31, 2020

New study finds deaf and hard of hearing women more likely to have pregnancy complications

Women who are deaf and hard of hearing have more pregnancy complications and worse outcomes than those without hearing impairment, a study indicates.

Michael M. McKee, M.D., M.P.H. and Kimberly S. McKee, Ph.D., M.P.H., co-authors

"After considering the demographic characteristics, deaf and hard of hearing (DHH) women were at increased risk of developing chronic diseases and having pregnancy complications, premature delivery and a baby with very low birth weight.” The analysis was led by Monika Mitra, Ph.D., the Nancy Lurie Marks Associate Professor of Disability Policy at Brandeis University, with co-authors Michael M. McKee, M.D., M.P.H., associate professor and director of MDisability, and Kimberly S. McKee, PhD., M.P.H., assistant professor. Their work is currently in-press and published online January 15, 2020 in the American Journal of Preventive Medicine.

READ ALSO: $2.8 million grant to study perinatal care and pregnancy outcomes for Deaf and hard of hearing women

4.7% of women of reproductive age in the United States report a hearing impairment. While their study suggests that the risk of complications in pregnancy and childbirth would increase in women with hearing impairments, a study by another team found similar results in women with and without hearing impairment.

With the Massachusetts Longitudinal Data Set on Pregnancy and Childhood, which includes all birth certificates, fetal mortality and hospital discharge records of babies born in the state and their mothers, the authors identified 1.19 million births of babies only in the period 1998-2013, including 1385 women with diagnosed hearing loss on their medical records.

These women were more likely than those without hearing impairment to be younger and African-American, have fewer years of schooling, have been born in the United States and have smoked during pregnancy. Several chronic diseases were more common in deaf and hard of hearing women, including diabetes, hypertension, gestational diabetes and preeclampsia or eclampsia. DHH women were also more likely to have a C-section and spend more than four days in the hospital after a vaginal delivery.

9.2% of the deliveries of DHH women were premature, compared with 7.1% of women without AD (p <0.01). 7.2% of the babies of DHH women had low birth weight, versus 5.6% of those of women without AD (p <0.05).

Very low birth weight, low height for gestational age and a low Apgar score were significantly more common in babies of deaf and hard of hearing women.

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The results "highlight the need for a systematic investigation of the pregnancy- and neonatal risks, complications, costs, mechanisms and outcomes of deaf and hard of hearing women," McKee and co-authors write.

In 2017, Monika Mitra and Michael M. McKee were awarded a five-year, $2.8 million grant from the National Institutes of Health (NIH) to study the pregnancy outcomes and experiences of women who are Deaf and hard of hearing. McKee leads the the Deaf Health Clinic at the Dexter Health Center, a tailored primary clinic for deaf and hard of hearing patients.

Additional authors include Ilhom Akobirshoev, Ph.D., Jianying Zhang, M.D., and Anne Valentine, M.P.H., of the Lurie Institute for Disability Policy at Brandeis University; Grant Ritter, Ph.D. of the Heller School for Social Policy and Management at Brandeis University; and senior author Lisa I. Iezzoni, M.D., of the Mongan Institute for Health Policy at Massachusetts General Hospital.

Article citation: Mitra M, Mckee MM, Akobirshoev I, et al. Pregnancy, Birth, and Infant Outcomes Among Women Who Are Deaf or Hard of Hearing. American Journal of Preventive Medicine. 2020. doi:10.1016/j.amepre.2019.10.012.