OBJECTIVE: To examine whether maternal prenatal alcohol, cannabis, or nicotine use was associated with offspring diagnoses of hearing loss during the first six months of life. METHODS: We conducted a population-based retrospective birth cohort study of infants (N = 297,147) born between 2011 and 2023 to pregnant individuals (N = 233,902) in Kaiser Permanente Northern California universally screened for any prenatal alcohol, cannabis, or nicotine use since pregnancy at entrance to prenatal care (at ∼8-10 weeks gestation). Offspring hearing loss was defined as ≥1 hearing loss diagnosis in the infant's electronic health record based on ICD codes. Modified Poisson regression models for binary data were used to estimate the risk ratio (RR) of infant hearing loss by each prenatal substance adjusting for covariates. RESULTS: The sample of pregnancies were to 23.9 % Asian/Pacific Islander, 5.3 % Black, 26.1 % Hispanic, and 37.7 % non-Hispanic White individuals, with a mean (SD) age of 32 (5.4) years
9.9 % screened positive for any alcohol use during early pregnancy, 5.6 % screened positive for any cannabis use during early pregnancy, and 3.9 % screened positive for any nicotine use during early pregnancy. Overall, 0.2 % of infants had a hearing loss diagnosis during the first six months of life. In fully adjusted models, prenatal alcohol use (adjusted RR:1.37
95 %CI:1.05-1.79) but not prenatal cannabis or nicotine use, was associated with increased risk of infant hearing loss. CONCLUSIONS: Maternal alcohol use during early pregnancy was associated with an increased risk of offspring diagnoses of hearing loss during the first six months of life.