Is a child's history of acute otitis media and respiratory infection already determined in the antenatal and perinatal period?

Abstract

A random sample of 2512 children were followed up from fetal period to the age of two years and the relation of various antenatal and perinatal factors to acute respiratory infection, wheezy bronchitis and otitis media was studied. A model containing the relationships between the variables was used as a basis for the analysis and the powerful confounding effects of postnatal factors were standardized. Acute otitis media with effusion (AOME) demonstrated by myringotomy was analyzed as a specific subgroup of acute otitis media (AOM). Low birth weight (≤ 2500 g) and prematurity (birth before the 37th gestational week) did not influence either AOM or AOME. The odds ratio for low birth weight infants becoming ‘otitis-prone’ (≥ 3 episodes of AOME) was 1.5 (0.9–2.1, P > 0.1). The various neonatal ventilation therapies were not associated with either AOM or AOME, but intermittent positive pressure ventilation, low birth weight and prematurity were distinctly related to wheezy bronchitis. The odds ratio regarding inter mittent positive pressure ventilation was 2.0 (1.0–3.0, P < 0.05) and that regarding low birth weight 1.7 (1.0–2.3, P < 0.05). Boys had a slightly increased risk with respect to all the infective parameters. Birth order was closely correlated with the infective parameters, but much of this correlation was due to the postnatal effect of siblings. Altogether the antenatal and perinatal factors had only a slight effect on the infective parameters studied.