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Recurrent acute otitis media. A prospective study of children during the first three years of life
G Harsten1, K Prellner, J Heldrup
1Department of Oto-Rhino-Laryngology, University Hospital, Lund, Sweden.
Insights
Early onset of acute otitis media (AOM) before six months predicts recurrent AOM (rAOM). Identifying risk factors like respiratory infections aids early intervention for children prone to ear infections.
Area of Science:
- Pediatrics
- Otolaryngology
- Epidemiology
Background:
- Recurrent acute otitis media (rAOM) affects numerous children, necessitating identification of predictive risk factors.
- Early intervention strategies for rAOM require understanding factors detectable before recurrence onset.
Purpose of the Study:
- To evaluate potential risk factors for developing recurrent acute otitis media (rAOM) in children.
- To determine if risk factors for rAOM can be identified early for timely intervention.
Main Methods:
- Prospective follow-up of 113 children from birth to 3 years.
- Defined rAOM as six or more episodes of acute otitis media (AOM) within 12 months.
- Collected data on respiratory infections, family history, and environmental factors.
Main Results:
- Onset of AOM before 6 months of age predicted rAOM in 80% of cases.
- Higher frequency of respiratory infections and family history of otitis-proneness observed in rAOM group.
- rAOM development was not linked to sex, allergy history, breastfeeding duration, or daycare attendance.
Conclusions:
- Early-onset AOM (before 6 months) is a strong predictor of rAOM.
- Prompt diagnosis in infants is crucial for managing potential recurrent ear infections.
- Identifying risk factors like respiratory infections can guide prophylactic measures.
Abstract:
To evaluate possible risk factors for developing recurrent acute otitis media (rAOM), 113 children were followed prospectively from birth to the age of 3 years. One of the aims was to determine whether such risk factors could be identified before the onset of the recurrences, so that optimal care and prophylactic measures could be made available at an early stage in such cases, on the basis of continuous follow-up by an ENT specialist. During the follow-up, 13 children developed rAOM, defined as six or more episodes of acute otitis media (AOM) during a 12-month period, 57 children had occasional episodes of AOM, and 43 children had no AOM at all. Of the children with onset of AOM before 6 months of age, 80% developed frequent episodes of AOM. The frequency of other respiratory tract infections and of family histories of otitis-proneness was higher among rAOM children than among the other children. The development of rAOM was unrelated to such factors as sex, familial history of allergy, duration of breast-feeding, or domestic environment. Nor could attendance at day-care centres be concluded as constituting a risk factor for the development of rAOM. An onset of AOM before 6 months of age was highly predictive of subsequent recurrent bouts of AOM, which emphasizes the importance of correct diagnosis in infants.