Abstract
Objectives
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.
Design
Population‐based prospective cohort study among 7,863 children from birth until 10 years and their mothers.
Methods
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 if specific determinants were associated with specific trajectories.
Results
Three distinct trajectories were identified; i.e., non‐otitis‐prone, early‐AOM – i.e. children who suffered AOM episodes until 3 years of age but not beyond, and persistent‐AOM – i.e. 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 trajectory (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.
Conclusion
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.
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