Low cord blood pneumococcal immunoglobulin G (IgG) antibodies predict early onset acute otitis media in infancy.
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.
Salazar
J C
JC
University of Minnesota School of Medicine, Department of Pediatrics, Minneapolis, USA.
Daly
K A
KA
Giebink
G S
GS
Lindgren
B R
BR
Liebeler
C L
CL
Meland
M
M
Le
C T
CT
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D000907:Antibodies, Bacterial / Q000097:blood*; D005312:Fetal Blood / Q000276:immunology*; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood*; D007231:Infant, Newborn; D008137:Longitudinal Studies; D008875:Middle Aged; D010033:Otitis Media / Q000276:immunology*; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D012306:Risk; D012703:Serotyping; D013296:Streptococcus pneumoniae / Q000145:classification / Q000276:immunology*
D000907:Antibodies, Bacterial; D007074:Immunoglobulin G