Ototoxicity in preterm infants: effects of genetics, aminoglycosides, and loud environmental noise

J Perinatol. 2013 Jan;33(1):3-8. doi: 10.1038/jp.2012.105. Epub 2012 Aug 9.


Majority of hearing-loss cases with extremely preterm infants have no known etiology. There is a growing concern that the administration of aminoglycoside treatment in the noisy environment of the Neonatal Intensive Care Unit (NICU) may lead to hair-cell damage and subsequent auditory impairments. In addition, several mitochondrial DNA mutations are known to have been associated with aminoglycoside-induced hearing loss. This review provides a systematic analysis of the research in this area and elucidates the multifactorial mechanisms behind how mitochondrial DNA mutations, aminoglycosides and loud noise can potentiate ototoxicity in extremely preterm neonates. Recommended steps to minimize the risk of ototoxicity and improve clinical care for NICU infants are discussed.

Publication types

  • Review

MeSH terms

  • Aminoglycosides / therapeutic use
  • Aminoglycosides / toxicity*
  • Anti-Bacterial Agents / therapeutic use
  • Anti-Bacterial Agents / toxicity*
  • DNA Mutational Analysis
  • DNA, Mitochondrial / genetics
  • Hair Cells, Auditory / drug effects
  • Hearing Loss / chemically induced*
  • Hearing Loss / genetics*
  • Hearing Loss / prevention & control
  • Hearing Loss, Noise-Induced / etiology*
  • Hearing Loss, Noise-Induced / prevention & control
  • Humans
  • Infant, Extremely Low Birth Weight*
  • Infant, Newborn
  • Infant, Premature, Diseases / chemically induced
  • Infant, Premature, Diseases / etiology*
  • Infant, Premature, Diseases / genetics
  • Infant, Premature, Diseases / prevention & control
  • Intensive Care Units, Neonatal*
  • Noise / adverse effects
  • Risk Factors


  • Aminoglycosides
  • Anti-Bacterial Agents
  • DNA, Mitochondrial