Risk of Hearing Loss in Neonates and Toddlers with in Utero Exposure to SARS‐CoV‐2

Objective Given the prevalence of neonatal hearing loss (HL) associated with intrauterine viral exposures, the goal of this study is to provide information on neonatal HL in the context of the COVID‐19 pandemic. Methods Data were drawn from the COVID‐19 Mother Baby Outcomes (COMBO) Initiative. 1007 participants completed the newborn hearing screen as part of routine clinical care (COMBO‐EHR cohort) and 555 completed the National Survey of Children's Health (NSCH) at 2 and/or 3 years of age for research purposes (COMBO‐RSCH cohort). Maternal SARS‐CoV‐2 infection status during pregnancy was determined through electronic health records and maternal‐reported questionnaires. Results In adjusted multivariate logistic regression models covarying for newborn age at assessment, mode of delivery, and gestational age at delivery, there was no significant association between intrauterine SARS‐CoV‐2 exposure and newborn hearing screening failure (OR = 1.05, 95% CI = 0.39–2.42, p = 0.91) in the COMBO‐EHR cohort. In the COMBO‐RSCH cohort, there were similar non‐significant associations between intrauterine exposure to SARS‐CoV‐2 and maternal‐reported concern for HL on the NSCH (OR = 1.19 [95% CI = 0.30–4.24], p = 0.79). Conclusion There is no association between intrauterine exposure to SARS‐CoV‐2 and failed hearing screen in neonates. Similarly, based on the NSCH, there is no association between intrauterine exposure to SARS‐CoV‐2 and maternal‐reported concern for hearing in toddlers. These results offer reassurance given the widespread nature of this pandemic with tens of millions of fetuses having a history of intrauterine exposure. Level of Evidence 4 Laryngoscope, 135:385–392, 2025 Pregnant women comprise a vulnerable patient population, susceptible to viral infections that can lead to congenital deficits in exposed newborns, including hearing loss. This study investigates the risk that intrauterine SARS‐CoV‐2 exposure may confer on neonatal hearing screen failure and childhood hearing loss up to 3 years of age.