Environmental determinants associated with acute otitis media in children: a longitudinal study

Abstract

Background

Acute otitis media (AOM) is a common pediatric disease and frequent reason for antibiotic treatment. We aimed to identify environmental and host factors associated with AOM and assess which determinants were associated with AOM at specific ages.

Methods

This study among 7863 children was embedded in the Generation R Study: a population-based prospective cohort study from fetal life onwards. Data on outcome and possible determinants were collected using questionnaires until 6 years. We used generalized estimating equation models to examine associations with AOM with longitudinal odds at different ages, considering correlations between repeated measurements.

Results

Male gender increased odds of AOM in children at 2, 3, and 4 years but not at other ages. Postnatal household smoking, presence of siblings, and pet birds increased odds of AOM. Breastfeeding decreased AOM odds, most notably in the first 2 months of life. No association was found for season of birth, maternal age, ethnicity, aberrant birth weight for gestational age, prenatal smoking, furry pets, and daycare attendance.

Conclusions

Risk of childhood AOM varies with age. Significant association with AOM was found for gender and breastfeeding at specific ages and for household smoking, presence of siblings, and pet birds at all the studied ages.

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Data availability

The data are available from the corresponding author upon request.

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Acknowledgements

The Generation R Study is being conducted by the Erasmus Medical Center in close collaboration with the School of Law and Faculty of Social Sciences of the Erasmus University Rotterdam, the Municipal Health Service Rotterdam area, Rotterdam, the Rotterdam Homecare Foundation, Rotterdam, and the Stichting Trombosedienst & Artsenlaboratorium Rijnmond (STAR-MDC), Rotterdam. We gratefully acknowledge the contributions of children and parents, general practitioners, hospitals, midwives, and pharmacies in Rotterdam. The general design of the Generation R Study was made possible by financial support from Erasmus MC, Rotterdam; Erasmus University, Rotterdam; the Netherlands Organization for Health Research and Development (ZonMw); the Netherlands Organization for Scientific Research (NWO); the Ministry of Health, Welfare, and Sport; and the Ministry of Youth and Families. The funders were not involved in the study design, data collection and analysis, decision to publish, or preparation of the manuscript.

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G.v.I. conceptualized and designed the study, performed the statistical analyses, and drafted the manuscript; C.M.P.l.C. assisted in conceptualizing and designing the study, assisted in data collection, supervised the statistical analyses, and reviewed the manuscript; C.E.T. coordinated and performed statistical analyses and assisted in drafting the manuscript; L.D. provided comments and consultation regarding statistical analyses and the manuscript; H.A.M. contributed to the original data collection of the Generation R Study and reviewed the manuscript for intellectual content; V.W.V.J. initiated and designed the Generation R Study, supervised data collection for the Generation R Study, and reviewed the manuscript; H.R. made important contributions the design of the Generation R study and reviewed the manuscript for important intellectual content; R.J.B.d.J. critically revised the manuscript and was responsible for the infrastructure of the study; M.P.v.d.S. conceptualized and designed the study, supervised analyses, and drafting of the manuscript; and all authors approved the final manuscript as submitted.

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Correspondence to Gijs van Ingen.

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van Ingen, G., le Clercq, C.M.P., Touw, C.E. et al. Environmental determinants associated with acute otitis media in children: a longitudinal study. Pediatr Res 87, 163–168 (2020). https://doi.org/10.1038/s41390-019-0540-3

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