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Was Ear Disorder's Link to Pregnancy a Nazi Plot?

Researcher disproves age-old medical assumption with new findings

FRIDAY, May 20, 2005 (HealthDay News) -- For the last 66 years, doctors have been taught that pregnancy can worsen a hearing-loss disease in women.

It now turns out that might not be true -- and who's to blame? Apparently, the Nazi government of wartime Germany.

Dr. William Lippy, an Ohio otologist and expert on otosclerotic surgery, reported this week on the results of a study that starkly refutes the long-accepted notion among physicians that pregnant women with otosclerosis -- a degenerative disease of the ear bone -- are at heightened risk of hearing loss and even deafness.

"We were able to prove that there was absolutely no significant correlation between pregnancy and hearing loss among women with otosclerosis," Lippy said. "Women with the disease who had children, regardless of how many, had no worse hearing than women who'd never had children."

In fact, Lippy traced the source for this misinformation to a 1939 seminar held by German physicians. At the time, their speculation of an otosclerosis-pregnancy link was used by the Nazi government to promote genetic purity in the Aryan race.

"The Nazis didn't want any genetic desecration propagated in the Aryan race," Lippy said.

He presented his findings this week at the Triological Society's annual meeting in Boca Raton, Fla.

Otosclerosis is a largely genetic disease that causes one of the bones of the inner ear to become fixed so that it cannot vibrate and transmit sound. The disorder affects women twice as often as men, and approximately half a million U.S. women suffer from otosclerosis, said Lippy, who performs surgery to repair the damaged ear bone and correct the hearing loss.

In most cases, those who suffer from hearing loss can wear hearing aids or have corrective surgery.

Lippy said he had believed, like other doctors, that otosclerosis was exacerbated by pregnancy. Then, years ago, he began to teach in Israel and noticed that among ultra-orthodox religious women with otosclerosis -- women who often have large families -- there appeared to be no worse hearing loss than among women with fewer or no children.

"These women had six, eight or 12 children, and it finally dawned on me that these women had no worse hearing than women with fewer or no children," he said.

Back at home, he and his colleagues conducted a retrospective study of 94 women who had undergone stapedectomy, the surgery that restores flexibility to the damaged ear bone so that hearing can resume.

Forty seven of the patients had children and 47 had no children, and Lippy found no significant correlation between the number of children and hearing loss, nor did breastfeeding affect the amount of hearing loss.

One of Lippy's patients, Sandra Eberlein, 44, of Lakewood, Ohio, found his news bittersweet.

The parents of two teenage daughters, Eberlein and her husband, a family physician, had planned on a family of four, but hearing losses that seemed connected to her pregnancies made her decide not to have any more children. Surgery by Lippy has restored her hearing.

"I left his office with an empty feeling. I'm grateful for the children we have, but I felt so cheated that we could have had four children. It was disappointing after all these years," she said.

Lippy said that the assumption that it was her pregnancies that caused her hearing loss was a combination of the misinformation in the medical community as well as the tendency for women to mark the events in their lives by their pregnancies.

"If you ask women, 'When did such and such happen,' they will relate things very much to their children," he said.

He said that no one knows what causes the acceleration of the disease -- hormonal changes, German measles in childhood, a vitamin D deficiency are among the causes being investigated -- but that pregnancy does not appear to be one of them.

Lippy said in researching the origins of the association between pregnancy and hearing loss in otosclerosis, he found a report of a seminar among eight German doctors who discussed whether the two could be related.

"Only two really believed that otosclerosis was really accelerated by pregnancy," he said, but the group were forced to refer their findings to a Nazi government agency.

From there a report was issued of guidelines from the German Reichgutacherstelle (Agency of Expert Opinion of the German Reich) concerning abortion and sterilization for eugenic reasons of terminating a genetic disease, Lippy wrote in the study.

The document then reported that out of 69 women with otosclerosis, 43 had an abortion and 23 were sterilized.

"One can't help but wonder whether it was science or political edict by the Nazis to purify the race that resulted in these actions," Lippy wrote in the study.

The Florida expert theorizes that this action by the Nazi regime helped propagate the persistent notion among doctors everywhere that pregnancy raises otosclerosis risks in affected women.

Experts believe the new findings may help change clinical practice and ease women's minds. "This is a good study and will help to bring relief to some women who are anxious about pregnancy," said Dr. Jeffrey Kim, an otologist at Georgetown University School of Medicine in Washington, D.C.

Kim said that he, like most specialists familiar with the literature on otosclerosis, have told young women with the disease that they could experience hearing loss if they get pregnant -- news that doesn't always make them decide against pregnancy but does make them a little hesitant about their condition.

While he believes further studies are needed to confirm Lippy's findings, Kim said he will now tell his patients about this findings to help alleviate some of their fears.

More information

The National Institutes of Health offers information on otosclerosis.

SOURCES: William Lippy, M.D., otolaryngologist, Warren, Ohio; Sandra Eberlein, Lakewood, Ohio; Jeffrey H. Kim, assistant professor of otolaryngology, Georgetown University School of Medicine, Washington, D. C.; May 16, 2005, presentation, Triological Society, annual meeting, Boca Raton, Fla.
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