Epidemiology of Otitis Media During the First Seven Years of Life in Children in Greater Boston: A Prospective, Cohort Study

TLDR

To determine the epidemiology of acute otitis media (AOM) and the duration of middle‑ear effusion (MEE) in children from birth to 7 years, we followed a prospective cohort of 877 children (698 observed for ≥3 years and 498 for the full 7 years). We analyzed longitudinal data accounting for dropouts, with 877 children observed for at least 1 year, 698 for at least 3 years, and 498 for the full 7 years. By age 1, 62 % of children had ≥1 AOM episode and 17 % had ≥3; by age 3, these figures rose to 83 % and 46 %, with peak incidence in the second 6‑month period, and multivariate analysis identified male gender, sibling history of recurrent AOM, early onset, and lack of breastfeeding as significant risk factors for AOM and prolonged middle‑ear effusion.

Abstract

To determine the epidemiology of acute otitis media (AOM) and duration of middle ear effusion (MEE), we followed consecutively enrolled children from shortly after birth until 7 y of age. Because some children dropped out of the study, data were analyzed for 877 children observed for at least 1 y; 698 were observed for at least 3 y, and 498 were observed until 7 y of age. By 1 y of age, 62% of the children had ⩾1 episode of AOM and 17% had ⩾3 episodes; by 3 y of age, 83% had ⩾1 episode of AOM and 46% had ⩾3 episodes. The peak incidence occurred during the second 6-mo period of life. Significantly increased risk (by multivariate analysis) for AOM was associated with male gender, sibling history of recurrent AOM, early occurrence of AOM, and not being breast fed. MEE persisted after onset of AOM for weeks to months; prolonged duration of MEE was associated with male gender, sibling history of ear infection, and not being breast fed.