Among 297,147 infants, prenatal alcohol use was associated with 37% increased risk of hearing loss, while prenatal cannabis and nicotine use showed no significant association.
Pregnant individuals, OB-GYNs, audiologists, and researchers studying prenatal substance exposure effects on infant development.
What the researchers found
Prenatal alcohol use was associated with increased infant hearing loss risk (aRR: 1.37, 95% CI: 1.05-1.79), but neither prenatal cannabis use nor nicotine use was significantly associated with hearing loss in the first six months of life.
Why it matters
This large study helps clarify which prenatal substance exposures specifically affect infant hearing. The null finding for cannabis provides reassurance on this particular outcome, while reinforcing alcohol's known developmental risks.
The numbers in context
297,147 infants. 9.9% prenatal alcohol exposure, 5.6% cannabis, 3.9% nicotine. 0.2% had hearing loss diagnosis. Alcohol: aRR = 1.37 (95% CI: 1.05-1.79). Cannabis and nicotine: not significant.
How the study worked
Population-based retrospective birth cohort of 297,147 infants born to 233,902 universally screened parents in Kaiser Permanente Northern California (2011-2023), using modified Poisson regression.
What this study cannot tell us
Low overall hearing loss prevalence (0.2%) limits statistical power for detecting smaller effects. Screening-based substance detection may undercount actual use. ICD-based hearing loss diagnosis may miss mild cases.
How to read the evidence
Very large population-based cohort with universal screening — strong evidence, though low hearing loss prevalence limits power for detecting small effects.
When this study was published
Recent study spanning 2011-2023, providing the first large-scale comparison of multiple prenatal substances and infant hearing outcomes.
The bigger picture
Not all substances carry the same risks for all outcomes. This study helps separate substance-specific effects on infant hearing, contributing to more nuanced prenatal counseling rather than blanket warnings.
Questions still open
- Does prenatal cannabis exposure affect other aspects of auditory processing not captured by hearing loss diagnoses? Are there dose-response relationships for alcohol's effect on hearing?
Common questions
Does cannabis use during pregnancy cause hearing problems in babies?
What prenatal substances affect infant hearing?
Read the original research
Alcohol, Cannabis, and nicotine use during early pregnancy and infant hearing loss.
Preventive medicine, 192, 108242
Citation
Young-Wolff, Kelly C; Oberman, Nina; Alexeeff, Stacey E; Croen, Lisa A; Steuerle, Kristin R; Ansley, Deborah; Castellanos, Carley; Avalos, Lyndsay A. (2025). Alcohol, Cannabis, and nicotine use during early pregnancy and infant hearing loss.. Preventive medicine, 192, 108242. https://doi.org/10.1016/j.ypmed.2025.108242
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