Department of Otolaryngology-Head and Neck Surgery, Erasmus MC, Rotterdam, The Netherlands.
The Generation R Study Group, Erasmus MC, Rotterdam, The Netherlands.
Clin Otolaryngol. 2021 Jul;46(4):788-795. doi: 10.1111/coa.13736. Epub 2021 Feb 21.
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.
Population-based prospective cohort study among 7863 children from birth until 10 years and their mothers.
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.
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.
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.
确定儿童急性中耳炎（AOM）可能存在的不同发病轨迹，并确定与特定 AOM 轨迹相关的决定因素。以探索哪些儿童易患复发性 AOM 发作，哪些不易患。
这是一项基于人群的前瞻性队列研究，纳入了 7863 名儿童及其母亲，从出生到 10 岁。
本研究是嵌入在 Generation R 研究中的：一项基于人群的前瞻性队列研究。通过反复的父母问卷调查收集有关 AOM 和决定因素的数据。采用潜在类别分析在人群中确定不同的 AOM 轨迹。接下来，使用多变量分析检查特定决定因素是否与特定轨迹相关。
确定了三种不同的轨迹，即非易患中耳炎、早发性 AOM（即儿童在 3 岁前有 AOM 发作，但之后没有）和持续性 AOM（即儿童持续易患中耳炎）。男性（比值比：1.26，95%置信区间：1.11-1.43）和日托（比值比：1.31，95%置信区间：1.06-1.60）与早发性 AOM 的发病风险增加相关。母乳喂养对早发性 AOM 和持续性 AOM 轨迹的儿童都有益（比值比分别为 0.78 和 0.77）。与春季出生相比，夏季或秋季出生降低了仅在持续性 AOM 轨迹中发生 AOM 的几率。所有易患 AOM 的儿童中有一半在 3 岁后恢复。
特定的决定因素与不同的 AOM 轨迹相关。需要进一步研究以更好地预测哪些儿童会持续易患中耳炎，哪些儿童在 3 岁后会恢复，从而更好地根据个体儿童的需求制定治疗方案。
