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Risk factors for recurrent acute otitis media and respiratory infection in infancy
Insights
Day care in local authority nurseries significantly increases the risk of acute otitis media (AOM) in young children. Shorter breastfeeding duration also elevates risks for recurrent respiratory infections and AOM.
Area of Science:
- Pediatrics
- Epidemiology
- Infectious Diseases
Background:
- Acute otitis media (AOM), respiratory infections, and wheezy bronchitis are common childhood illnesses.
- Understanding risk factors is crucial for prevention and management strategies.
Purpose of the Study:
- To investigate the relationship between various risk factors and the incidence of AOM, respiratory infections, and wheezy bronchitis in children up to two years old.
- To analyze the interrelations of risk factors and standardize confounding antenatal parameters.
Main Methods:
- A cohort-based design with random enrollment of 2512 children from the fetal period to age two.
- Multivariate analysis was employed to separate complex risk factor interrelations.
- Acute otitis media with effusion (AOME) was analyzed as a subgroup of AOM.
Main Results:
- Day care in local authority nurseries emerged as the primary risk factor for both AOM and AOME (OR 1.8).
- Shorter breastfeeding duration was linked to increased risk of recurrent respiratory infections (OR 1.3) and AOME (OR 1.5).
- Allergy and family day care showed significant, though lesser, associations with infective parameters. Wheezy bronchitis shared risk factors with infections.
Conclusions:
- Day care attendance and short breastfeeding duration are significant risk factors for common childhood respiratory infections and otitis media.
- Wheezy bronchitis appears to be closely associated with infectious processes in early childhood.
Abstract:
Using a cohort-based design and random enrollment, the relation of various risk factors to acute otitis media, respiratory infection and wheezy bronchitis was studied in 2512 children from the fetal period to the age of two years. The complex interrelations of the risk factors with each other were separated out by multivariate analysis, and the confounding effects of antenatal parameters were also standardized. Acute otitis media with effusion (AOME), as demonstrated by myringotomy, was analyzed as a specific subgroup of acute otitis media (AOM). Day care in local authority nursery was the major risk factor for both types of acute otitis media. The odds ratio (OR) for such children becoming 'otitis-prone' (greater than or equal to 3 episodes of AOME) was 1.8 (95% confidence interval, 1.4-2.2). Short duration of breastfeeding involved another significant risk of recurrent respiratory infections and otitis media, the OR for AOME being 1.5 (1.1-2.0) and that for recurrent respiratory infection 1.3 (1.1-1.6). Allergy and family day care were also significantly associated with infective parameters, but to a lesser extent. The risk factors for wheezy bronchitis were the same as for infections, indicating that wheezy bronchitis is closely related to infections.