Identifying distinct trajectories of acute otitis media in children: A prospective cohort study
Gijs van Ingen1,2, Carlijn M P le Clercq1,2, Vincent W V Jaddoe2,3,4
1Department of Otolaryngology-Head and Neck Surgery, Erasmus MC, Rotterdam, The Netherlands.
Insights
Three distinct childhood acute otitis media (AOM) trajectories were identified: non-otitis prone, early AOM, and persistent AOM. Determinants like male gender and daycare increased early AOM risk, while breastfeeding offered protection.
Area of Science:
- Pediatrics
- Epidemiology
- Child Health
Background:
- Acute otitis media (AOM) is a common childhood illness with varying recurrence patterns.
- Understanding distinct AOM trajectories is crucial for targeted interventions.
- Predicting which children remain prone to recurrent AOM is a significant clinical challenge.
Purpose of the Study:
- To identify distinct acute otitis media (AOM) trajectories in childhood.
- To determine factors associated with specific AOM trajectories.
- To predict which children are likely to develop recurrent AOM.
Main Methods:
- A population-based prospective cohort study of 7863 children from birth to 10 years.
- Latent-class analysis used to identify distinct AOM trajectories.
- Multivariate analysis examined associations between determinants and AOM trajectories.
Main Results:
- Three trajectories identified: non-otitis prone, early AOM (until 3 years), and persistent AOM.
- Male gender and daycare attendance were associated with increased odds of early AOM.
- Breastfeeding showed a protective effect in both early and persistent AOM trajectories. Birth season influenced persistent AOM risk.
Conclusions:
- Specific determinants are linked to different AOM trajectories.
- Further research is needed to predict persistent otitis proneness for individualized treatment.
- Identifying children who recover from AOM after age 3 is key for tailored care.
Objectives:
To identify possibly distinct acute otitis media (AOM) trajectories in childhood and identify determinants associated with specific AOM trajectories. To explore which child will become prone to recurrent AOM episodes and which will not.
Design:
Population-based prospective cohort study among 7863 children from birth until 10 years and their mothers.
Methods:
This study was embedded in the Generation R Study: a population-based prospective cohort study. Data on AOM and determinants were collected by repeated parental questionnaires. Distinct AOM trajectories within the population were identified with latent-class analyses. Next, using multivariate analysis we checked whether specific determinants were associated with specific trajectories.
Results:
Three distinct trajectories were identified; that is, non-otitis prone, early AOM-that is children who suffered AOM episodes until 3 years of age but not beyond, and persistent AOM-that is children who remained otitis-prone. Male gender (OR: 1.26, CI: 1.11-1.43) and day-care attendance (OR: 1.31, CI: 1.06-1.60) were associated with increased odds of early AOM. Breastfeeding was beneficial for children in both the early-AOM and persistent-AOM trajectories (OR: 0.78 and 0.77, respectively). Birth in the summer or autumn as compared with birth in the spring decreased odds of AOM only in the persistent-AOM trajectory. Half of all AOM-prone children recovered after the age of 3 years.
Conclusion:
Specific determinants are associated with different AOM trajectories. Future research is needed to better predict which child will remain otitis-prone and which recovers after the age of 3 years to better tailor treatment towards the needs of the individual child.
