The association between gestational age and otitis media during childhood: a population-based cohort analysis

J Dev Orig Health Dis. 2019 Apr;10(2):214-220. doi: 10.1017/S2040174418000685. Epub 2018 Sep 18.

Abstract

Otitis media (OM) carries a tremendous global health burden and potentially severe long-term consequences. The objective of this study was to determine the impact of birth at different gestational ages on the incidence of childhood OM.A population-based cohort analysis was conducted. All singleton deliveries occurring between 1991 and 2014 at a regional tertiary medical center were included. Gestational age on delivery was divided into six subgroups: early (<34 weeks gestation; 0 out of 7) and late (34 weeks gestation; 0 out of 7 to 36 weeks gestation; 6 out of 7) preterm, and early (37 weeks gestation; 0 out of 7 to 38 weeks gestation; 6 out of 7), full (39 weeks gestation; 0 out of 7 to 40 weeks gestation; 6 out of 7), late (41 weeks gestation; 0 out of 7 to 41 weeks gestation; 6 out of 7) and post (⩾42 weeks 0 out of 7) term deliveries. Rates of OM-related hospitalizations up to 18 years of age were assessed. Weibull parametric hazards model was used to study the association between gestational age at birth and the risk for OM-related hospitalizations while controlling for potential confounders.During the study period, 238,622 deliveries met the inclusion criteria. OM-related hospitalizations of the offspring (n=4724) were significantly more common in the preterm (early 3.6%, late 2.4%) and early-term born children (2.2%) and decreased gradually across the full (1.9%), late (1.7%) and post (1.6%) term groups (χ2-test for trends P<0.001). In the Weibull regression model, early preterm, as well as early-term deliveries exhibited an independent association with pediatric OM (adjusted hazard ratios: 1.67 and 1.09, respectively, P<0.02).Deliveries occurring at preterm and early term are associated with higher rates of pediatric OM-related hospitalizations, which decrease gradually as gestational age advances.

Keywords: follow-up; infection; offspring; pediatric morbidity; pregnancy.

MeSH terms

  • Adolescent
  • Age Factors
  • Child
  • Child, Preschool
  • Female
  • Gestational Age*
  • Hospitalization / statistics & numerical data
  • Humans
  • Incidence
  • Infant, Newborn
  • Infant, Postmature / immunology*
  • Infant, Premature / immunology*
  • Israel / epidemiology
  • Male
  • Otitis Media / epidemiology*
  • Otitis Media / immunology
  • Otitis Media / therapy
  • Retrospective Studies
  • Risk Factors