Owen M J, Baldwin C D, Swank P R, Pannu A K, Johnson D L, Howie V M
Department of Pediatrics, University of Texas Medical Branch, Galveston 77555-0319.
J Pediatr. 1993 Nov;123(5):702-11. doi: 10.1016/s0022-3476(05)80843-1.
The relation of infant feeding practices, cigarette smoke exposure, and group child care to the onset and duration of otitis media with effusion (OME) was evaluated in a cohort of 698 healthy infants prospectively monitored by tympanometry in the home every 2 to 4 weeks until 2 years of age. Except for an experimental group of children who were offered early tube placement, the study children received conventional care from their personal physician or clinic. We used LISREL, a structural equation modeling procedure (computer software), to explore associations between environmental variables and OME onset and duration while controlling for interrelations among the variables. Supine feeding position and early initiation of group child care were associated with earlier onset of OME. Shorter duration of breast-feeding, increased packs of cigarettes smoked per day in the home, and increased hours per week in group child care were associated with an increase in the amount of time with OME during one or more of the age blocks studied (birth to 6, 6 to 12, 12 to 18, and 12 to 24 months). For a decrease in the amount of time with OME during the first 2 years of life, prolonged breast-feeding and upright feeding position should be encouraged, and cigarette smoke exposure should be minimized. Limiting early child care in large groups might also be advisable.
在一项队列研究中，对698名健康婴儿进行了评估，通过每2至4周在家中进行一次鼓室导抗图监测，直至2岁，以探讨婴儿喂养方式、接触香烟烟雾和集体儿童保育与中耳积液（OME）发病及病程之间的关系。除了一个接受早期置管的实验组儿童外，研究中的儿童均接受其私人医生或诊所提供的常规护理。我们使用结构方程建模程序LISREL（计算机软件），在控制变量间相互关系的同时，探究环境变量与OME发病及病程之间的关联。仰卧位喂养姿势和较早开始集体儿童保育与OME较早发病有关。母乳喂养时间较短、家中每日吸烟包数增加以及每周在集体儿童保育机构的时长增加，与所研究的一个或多个年龄组（出生至6个月、6至12个月、12至18个月以及12至24个月）中耳积液时间增加有关。为了减少生命最初2年中耳积液的时间，应鼓励延长母乳喂养和采用直立位喂养姿势，并尽量减少接触香烟烟雾。限制幼儿在大型集体机构中的保育时间可能也是可取的。
