World Prematurity Day: Why Hearing Loss Risks are Higher for Preemies

November 17, 2025 – (Innsbruck, Austria): November 17 marks World Prematurity Day, a day dedicated to raising awareness of the global challenges and burdens of preterm birth. On this occasion, MED-EL, a leading hearing implant manufacturer, underlines the critical need for long-term audiological follow-up and early hearing loss treatment for this high-risk group.

• Globally, 1 in 10 babies is born too early
• Children born 8 or more weeks early and/or weighing less than 1,500 grams face the highest risk of permanent sensorineural hearing loss
• Cochlear implants offer a viable hearing solution for affected preterm infants – with special timing and developmental considerations.
  

According to the World Health Organization (WHO), 1 in 10 babies is born preterm, i.e. in or before the 37th week of pregnancy. Many survivors face a lifetime of disability, including hearing loss. Permanent hearing impairment is diagnosed in 2% to 10% of preterm infants compared to only 0.1% of the general paediatric population (Cochrane Database, 2024).

But what makes “preemies”, as they are affectionately called, such a high-risk group? 
The most common risk factors include:
- Low gestational age and birth weight
- Immature hearing pathways
- Use of ototoxic (ear-damaging) medication
- Prolonged mechanical ventilation (more than 5 days)
- Excessive noise levels in Neonatal Intensive Care Units (NICUs) and incubators

Children born before 32 weeks of pregnancy, that is, eight weeks or more too early, or with a birth weight of less than 1,500 grams face the highest risk of permanent hearing loss. Essential bodily functions, including the respiratory system and hearing pathways, are often not fully developed in preterm babies, making their immature brains more vulnerable to damage.

Survival and Hearing Challenges

Very preterm babies often spend their first weeks of life in incubators in NICUs, where they are exposed to noise levels typically ranging from 45 dB to 70 dB over a long period of time, far exceeding the recommended 45 dB by international pediatric associations. This prolonged exposure poses significant risks to their hearing.

Mechanical ventilation to support these infants’ breathing produces substantial noise, which is unavoidable due to its critical purpose. Additionally, lifesaving ototoxic drugs like aminoglycoside antibiotics and loop diuretics can further compromise hearing but are often necessary for survival.

Audiological challenges and solutions

Immature neonates, born as early as 24 weeks of pregnancy and often weighing as little as 400 grams, may show an interesting phenomenon of delayed maturation of hearing pathways. This makes audiological assessments challenging, as hearing can improve or deteriorate up to 12 months of their corrected age, as research has shown (Frezza et al., 2019).

Preemies with severe to profound sensorineural hearing loss qualify for cochlear implants (CIs), just like babies born at term. However, due to their unique maturation, researchers recommend postponing implantation until hearing thresholds are stable.

Studies comparing the long-term outcomes of preterm babies with cochlear implants to those of full-term babies with CIs demonstrate similar performance in both groups. After five years of CI use, language development of the preterm babies was only slightly below that of children born at term. (Robertson et al., 2022).

“Children born prematurely are a high-risk group for hearing loss. We want to raise awareness of potential modifiable risks such as lowering the dose of ototoxic drugs and decreasing noise levels in NICUs whenever possible to avoid damage to the immature brain of the littlest ones”, says Patrick D’Haese, Corporate Director of Awareness and Public Affairs at MED-EL and a trained audiologist. “Unstable hearing thresholds of preterm babies pose unique challenges to hearing specialists and need to be monitored long-term. Hearing aids for young preemies with hearing loss can promote auditory pathway maturation. For preterm babies whose hearing does not improve, cochlear implants are a viable option,” he adds.  

More information on cochlear implants and hearing rehabilitation for children can be found on the MED-EL website.

About MED-EL

MED-EL Medical Electronics, a leader in implantable hearing solutions, is driven by a mission to overcome hearing loss as a barrier to communication and quality of life. The Austrian-based, privately owned business was co-founded by industry pioneers Ingeborg and Erwin Hochmair, whose ground-breaking research led to the development of the world’s first micro-electronic multi-channel cochlear implant (CI), which was successfully implanted in 1977 and was the basis for what is known as the modern CI today. This laid the foundation for the successful growth of the company in 1990, when they hired their first employees. To date, MED-EL has more than 3,000 employees from around 90 nations and 30 locations worldwide.
The company offers the widest range of implantable and non-implantable solutions to treat all types of hearing loss, enabling people in 139 countries enjoy the gift of hearing with the help of a MED-EL device. MED-EL’s hearing solutions include cochlear and middle ear implant systems, a combined electric acoustic stimulation hearing implant system, auditory brainstem implants as well as surgical and non-surgical bone conduction devices. www.medel.com 

CEO

Doz. DI Dr DDr med. h.c. Ingeborg Hochmair

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