Analytical Study of Microtia Risk Factors in Indonesia

Abstract

Objective

This study aimed to evaluate the characteristics and risk factors associated with microtia at Airlangga University Hospital.

Design

A retrospective and unmatched case–control study involving 354 microtia patients and 354 controls, using convenience sampling from regions across western to eastern Indonesia.

Setting

Airlangga University Hospital, a national referral center for microtia in Indonesia.

Participants

Patients and controls were recruited through online questionnaires.

Interventions

None; data were collected using Google Forms.

Main Outcome Measures

Prevalence, laterality, severity (Hunter's Classification), and potential risk factors, including parental health, smoking exposure, folic acid intake, TORCH vaccination, and family history.

Results

Microtia was more prevalent in males (78%) with a male-to-female ratio of 3.53:1 (P < .001). Unilateral cases dominated (80.2%), mainly affecting the right ear (61.3%). Grade 3 microtia was most common (59%). After performing multiple unconditional logistic regression analyses, significant risk factors associated with the microtia group included maternal history of miscarriage/stillbirth (adjusted odds ratio [AOR] = 4.74-4.96), diabetes (AOR = 6.46), hypertension (AOR = 4.18), maternal smoking (AOR = 2.06), paternal smoking (AOR = 2.42-2.83), lack of TORCH vaccination (AOR = 1.59-2.02), and family history (AOR = 5.36), all with P value < .05.

Conclusions

Microtia in Indonesia reflects global patterns, with male predominance and right-sided unilateral cases. Associated risk factors include parental smoking, maternal comorbidities, lack of TORCH vaccination, and genetic predisposition. Public health strategies should promote smoking cessation, prenatal care, and vaccination. Further studies should ensure matching between the control and microtia groups, minimize recall bias, and explore genetic links.