Which chemotherapy drugs in pregnancy matter to Hearing Screeners?

Mrs Delene Thomas1

 1Healthy Hearing Program, Queensland, Pullenvale, Brisbane, Australia


Cancer during pregnancy is rare, but does complicate 0.02% to 0.1% of pregnancies annually. Women are leaving child bearing until much later in their lives. Therefore, the incidences of age dependant cancers are increasing. These include breast cancer, cervical cancer, thyroid cancer, Hodgkin’s lymphoma, and non-Hodgkin’s lymphoma.

Critically, for the best chance of survival of the mother, chemotherapy cannot always be postponed until the end of the pregnancy. These life-saving properties can have toxic impacts to the cochlea and result in hearing loss to the mother.

There is scare information regarding the fetal safety of maternal chemotherapy during pregnancy. A rapid review of information currently available was streamlined for Nurse Screeners in Queensland. The main purpose of identifying which, if any of the many chemotherapy drugs used in pregnancy might pose a risk to the new baby’s hearing in the longer term.

This review indicated not all chemotherapy drugs given to the pregnant women pose a risk to the fetus’ hearing. Of concern are the platinum compounds of Cisplatin and Carboplatin. These drugs can be retained at levels far higher in the cochlea than other organs, in some cases 18 months after the last treatment. Potential impacts of ototoxicity affect the outer hair cells, and cells in the basal area of the cochlea, and the high frequency range first. It is documented children are more susceptible to cisplatin induced hearing loss than adults.

This presentation will conclude with recommendations on which babies could be reliably referred for ongoing hearing assessment under the banner of Professional concern in the absence of firm evidence.


Delene is a member of the Queensland Healthy Hearing state-wide team supporting Nurses and Midwives to delivery a high quality screening service to local families.