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Published on: August 7, 2017
Otitis media incidence and risk factors in a population-based birth cohort
Elaina A Macintyre1, Catherine J Karr, Mieke Koehoorn
1School of Environmental Health, University of British Columbia, Vancouver, British Columbia;
Insights
Otitis media is common in young children, with nearly half experiencing it. Key risk factors include young maternal age, smoking during pregnancy, and Aboriginal ancestry.
Area of Science:
- Pediatrics
- Public Health
- Epidemiology
Background:
- Otitis media is a primary reason for antibiotic prescriptions and physician visits in young children.
- Understanding otitis media incidence and recurrence is crucial for public health interventions.
Purpose of the Study:
- To determine the incidence, recurrence rates, and associated risk factors of otitis media.
- To establish a population-based birth cohort for otitis media research.
Main Methods:
- A cohort of children born in southwestern British Columbia (1999-2000) was followed to age three.
- Otitis media diagnosis was based on ICD-9 codes from physician visits, linked with antibiotic prescriptions.
- Data on various demographic and socioeconomic factors were collected from multiple administrative databases.
Main Results:
- Nearly half of the 50,474 children studied (48.6%) had at least one otitis media visit.
- Recurrent otitis media (≥3 visits) affected 7.8% of children, with 73% of initial visits occurring in the first year of life.
- Significant risk factors identified included Aboriginal status, maternal age <20 years, male sex, and presence of older siblings.
Conclusions:
- Linking administrative databases effectively created a population-based cohort for otitis media study.
- While overall incidence is low in the region, young maternal age, maternal smoking, and Aboriginal ancestry are significant risk factors.
- These findings highlight specific populations at higher risk for otitis media, informing targeted prevention strategies.
Background:
Otitis media is the main reason young children receive antibiotics and is the leading reason for physician visits.
Objective:
To characterize the incidence, recurrence and risk factors for otitis media in a population-based birth cohort.
Methods:
All children born in southwestern British Columbia during 1999 to 2000 were followed until the age of three years. Otitis media was defined using The International Classification of Diseases, Ninth Revision coding of physician visits, and linked with antibiotic prescription data. Information on sex, birth weight, gestational age, Aboriginal status, maternal age, older siblings, maternal smoking during pregnancy, breastfeeding initiation, neighbourhood income, female education and rural residence were obtained from vital statistics, birth hospitalizations, perinatal registry and census data.
Results:
Complete risk factor information was available for 50,474 children (86% of all births). Nearly one-half of the children (48.6%) had one or more physician visits for otitis media during follow-up, and 3952 children (7.8%) met the definition for recurrent otitis media. Of the children with at least three visits during follow-up (n=7571), 73% had their initial visit during the first year of life. Aboriginal status, maternal age younger than 20 years, male sex and older siblings were the strongest risk factors identified in the adjusted conditional logistic regression models.
Discussion:
The present study established a population-based birth cohort by linking multiple administrative databases to characterize the incidence of and risk factors for otitis media. Although the incidence of otitis media is generally low in southwestern British Columbia, important risk factors continue to be young maternal age, mothers who smoke during pregnancy and children with Aboriginal ancestry.
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