Hearing assesment in children after intrauterine exposure to platinum-based treatment of pregnant cancer patients: A study from the International Network on Cancer, Infertility and Pregnancy

Background: Literature on the effects of prenatal exposure to platinum-based chemotherapy on the auditory capacity of the offspring is scarce. The current study aims to describe the occurrence of hearing impairment in a well-documented series of children who underwent audiological testing. Methods: An international, descriptive multicentre study using oncological, obstetrical, and neonatal data registered by the International Network of Cancer Infertility and Pregnancy database, was performed. The offspring (aged ≥ 4 years) underwent pure tone audiometry. Audiological outcomes were registered after expert review, using international standardized audiological grading as developed for platinum exposed childhood cancer patients: the Muenster criteria and the International Society for Paediatric Oncology classification. Platinum-induced hearing loss was defined as bilateral hearing loss, starting at 8 kHz and without middle ear problems confirmed by tympanometry or otoscopy. Findings: Twenty-five children were included of which 17 children (68%) had been exposed to cisplatin and 8 (32%) to carboplatin, none to both. Median gestational age at start maternal treatment was 22 weeks (range, 14–31). Median gestational age at delivery was 35 weeks (range, 31–39), and median birth weight was 2345 g (range, 1526–3360). Neonatal hearing screening, performed in 10 children (40%), showed no hearing loss. At a median age of 6.0 years (range, 4.0–28.0), 6 children (24%) revealed bilateral hearing loss, using cut-off values of Muenster grade ≥ 2b and SIOP grade ≥ 2. Interpretation: Antenatal exposure to platinum-based chemotherapy is associated with hearing loss in a subset of the offspring. Prospective longitudinal standardized surveillance of auditory function is advised, starting after birth.