title: Risk factors for chronic otitis media with effusion in infancy. Each acute otitis media episode induces a high but transient risk.
abstract: OBJECTIVE
  To examine the effects of a history of acute otitis media and different extrinsic factors on the risk of chronic otitis media with effusion in infancy.
  
  
  METHODS
  A retrospective birth cohort with a 2-year follow-up. Infection data were gathered from medical records and background information came from questionnaires. The monthly risk of chronic otitis media with effusion was dynamically modeled to control the confounding effects and time-dependency of the risk factors.
  
  
  METHODS
  Primary health care centers, hospitals, and private practices in 10 randomly selected local government districts in the two northern most provinces of Finland.
  
  
  METHODS
  A random sample of 2512 children from the cohort.
  
  
  METHODS
  Chronic otitis media with effusion, defined as a minimum of 2 months of middle-ear effusion, usually is disclosed by tympanocentesis and specific operative findings.
  
  
  RESULTS
  Previous acute otitis media episodes were the greatest risk factor. Each acute episode induced a highly increased risk (odds ratio, 11.9; 95% confidence interval, 5.7 to 24.9) that disappeared in 3 months. Successive episodes were risky, but this risk also decreased rapidly. Other significant risk variables were attendance at a day nursery (odds ratio, 2.56; confidence interval, 1.17 to 5.57), male sex (odds ratio, 2.17; confidence interval, 1.37 to 3.44), and autumn season (odds ratio, 1.99; confidence interval, 1.11 to 3.55).
  
  
  CONCLUSIONS
  Acute otitis media episodes constitute the greatest risk of chronic otitis media with effusion. Each episode has a high transient risk for 3 months but no further direct effect on the risk.
authors.affiliation: Department of Otolaryngology, University of Oulu, Finland.
authors.forename: O P
authors.initials: OP
authors.lastname: Alho
authors.forename: H
authors.initials: H
authors.lastname: Oja
authors.forename: M
authors.initials: M
authors.lastname: Koivu
authors.forename: M
authors.initials: M
authors.lastname: Sorri
mesh_terms: D000208:Acute Disease; D002908:Chronic Disease; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D016015:Logistic Models; D008297:Male; D010033:Otitis Media / Q000503:physiopathology*; D010034:Otitis Media with Effusion / Q000453:epidemiology / Q000209:etiology*; D012189:Retrospective Studies; D012307:Risk Factors