Early acute otitis media: Predictor for AOM and respiratory infections in schoolchildren?
Early acute otitis media: Predictor for AOM and respiratory infections in schoolchildren?
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DOI：
10.1016/j.ijporl.2007.04.017
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发表时间：
2007-08-01
影响因子：
1.5
通讯作者：
Kvaerner, Kari J.
中科院分区：
文献类型：
--
作者：
Bentdal, Yngvild E.;Karevold, Gunnhild;Kvaerner, Kari J.
目的：据报道，急性中耳炎（AOM）和呼吸道感染性疾病在小学生中仍然很常见。然而，早期开始AOM对后来呼吸道感染的意义尚不清楚。该研究的目的是评估早期开始急性中耳炎是否是小学生急性中耳炎和其他呼吸道感染的预测因素，以及早期生活中的环境暴露和宿主因素是否可以预测以后的急性中耳炎。方法：对1992/93年在奥斯陆出生的3754名儿童进行以人群为基础的前瞻性研究，其中2549名儿童从出生到10岁。主要结局指标为6个月、1岁和10岁时AOM和其他呼吸道感染的问卷调查信息。结果：在190例（5.3%）在6个月前有一次或多次AOM发作的儿童中，97例（51.1%）在6个月后仍然易感。6 ~ 12个月间发生1次或1次以上AOM的患儿总数为812例（25.1%）。在10岁的336例（13.2%）急性中耳炎患者中，95例（28.3%）在第一年也患有急性中耳炎。624名（24.4%）儿童在10岁时出现一次或多次扁桃体咽炎或下呼吸道感染。男孩在一岁时患急性中耳炎占多数，而女孩在10岁时更容易患急性中耳炎。出生第一年的AOM与10岁时的AOM相关性不强，粗比值比为1.3 (95% CI 1.0-1.6)，校正比值比为1.2 （95% CI 0.9-1.5）。其他呼吸道感染（扁桃体咽炎或下呼吸道感染）在10岁时也有相应的趋势。出生时接触烟草烟雾，早期生活中的特应性湿疹和中耳炎手术增加了10岁时AOM的风险。结论：我们发现小学生早期急性中耳炎和急性中耳炎与其他呼吸道感染之间没有很强的联系。父母出生时吸烟、早期特应性湿疹和女性与10岁儿童中耳炎的相关性较弱，而中耳炎手术与学龄儿童中耳炎的相关性较强。2007爱思唯尔爱尔兰有限公司版权所有。
Objective: It has been reported that acute otitis media (AOM) and respiratory infectious morbidity still are common in schoolchildren. However, the significance of early initiation of AOM on later respiratory infections is not known. The aim of the study was to assess whether early initiation of AOM is a predictor for AOM and other respiratory infections in schoolchildren, and if environmental exposures and host factors in early life predict later AOM.Methods: A population-based, prospective study of 3754 children born in Oslo in 1992/93, of which 2549 children were followed from birth to 10 years. Main outcome measures were questionnaire-based information on AOM and other respiratory infections at ages 6 months, 1 year and 10 years.Results: Of the 190 (5.3%) children with one or more episodes of AOM before 6 months, 97 (51.1%) remained susceptible the next 6 months. The total number of children with one or more episodes of AOM from 6 to 12 months was 812 (25.1%). Of the 336 (13.2%) with AOM at 10, 95 (28.3%) also had AOM the first year of life. One or more episodes of tonsillopharyngitis or lower respiratory infections were experienced in 624 (24.4%) of the children at 10 years. There was a predominance of boys with AOM the first year of life, while girls were more prone to AOM at age 10. AOM the first year of life was not strongly associated with AOM at age 10 with crude and adjusted odds ratios 1.3 (95% CI 1.0-1.6) and 1.2 (95% CI 0.9-1.5), respectively. A corresponding tendency was found for other respiratory infections (tonsillopharyngitis or lower respiratory infections) at age 10. Tobacco smoke exposure at birth, early life atopic eczema and otitis media surgery increased the risk of AOM at age 10.Conclusions: We found no strong association between early AOM and AOM and other respiratory infections in schoolchildren. Parental smoking at birth, early life atopic eczema and female gender were only weakly associated with AOM in 10-year olds while otitis media surgery was strongly associated with AOM in schoolchildren. (c) 2007 Elsevier Ireland Ltd. All rights reserved.