Low cord blood pneumococcal immunoglobulin G (IgG) antibodies predict early onset acute otitis media in infancy

Am J Epidemiol. 1997 Jun 1;145(11):1048-56. doi: 10.1093/oxfordjournals.aje.a009061.


Low maternally derived serum immunoglobulin G (IgG) antibodies to Streptococcus pneumoniae capsular polysaccharides (PS) combined with the inability of infants to produce anti-PS antibody may explain onset of otitis media in the first 6 months of life. To explore this relation, cord blood samples were assayed for anti-PS IgG antibodies from 414 of 592 infants enrolled in a study of early onset otitis media between 1991 and 1994. Infants' ears were examined at health supervision and illness visits for the first 6 months of life in a large Minneapolis-St. Paul, Minnesota, health maintenance organization. Antibodies to seven common pneumococcal serotypes (3, 4, 6B, 14, 18C, 19F, and 23F) were measured by enzyme-linked immunoabsorbent assay (ELISA). Cox's regression analysis revealed that among infants with a sibling otitis media history, those with low concentrations of type 14 or 19F anti-PS cord blood antibody had earlier otitis media onset than those with higher cord blood antibody concentrations (relative risks (RR) (95% confidence intervals (CI)) = 1.77 (1.05-2.99) and 1.89 (1.11-3.23), respectively). Day care attendance also increased risk (RR = 1.56, 95% CI 0.96-2.52). Breastfeeding, parental smoking, and low anti-PS antibody to pneumococcal serotypes 3, 4, 6B, 18C, and 23F did not significantly affect the risk of early otitis media.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Acute Disease
  • Adolescent
  • Adult
  • Age of Onset
  • Antibodies, Bacterial / blood*
  • Fetal Blood / immunology*
  • Humans
  • Immunoglobulin G / blood*
  • Infant, Newborn
  • Longitudinal Studies
  • Middle Aged
  • Otitis Media / immunology*
  • Predictive Value of Tests
  • Proportional Hazards Models
  • Risk
  • Serotyping
  • Streptococcus pneumoniae / classification
  • Streptococcus pneumoniae / immunology*


  • Antibodies, Bacterial
  • Immunoglobulin G