Day care in relation to respiratory-tract and gastrointestinal infections in a German birth cohort study.
OBJECTIVE
To describe day care attendance in Germany today (in former East and former West Germany). To investigate longitudinally whether children attending day care centres have an increased risk of acquiring common cold, bronchitis, pneumonia, otitis media or diarrhea.


METHODS
Questionnaire information was collected when the children in the cohort were 6, 12, 18, 24 months, and 4 and 6 years old. Day care within the first and first 2 years of life was investigated longitudinally with GEE (generalised estimating equations) methods in relation to common cold, bronchitis, pneumonia, otitis media and diarrhea within the first 6 years of life.


RESULTS
Day care centre attendance is more common in former East than in former West Germany; this difference is evident even 10-12 years after German reunification. Children attending a day care centre were more likely to have common cold, bronchitis, pneumonia, otitis media and diarrhea within the first 2-3 years of life. With the exception of common cold, from year 4 onwards these associations were not statistically significant anymore and even reversed for some of the infections.


CONCLUSIONS
Children attending day care centres were at an increased risk of respiratory and gastrointestinal infections within the first years of life. However, around school age these differences disappeared or even partly reversed.
GSF-National Research Center for Environment and Health, Institute of Epidemiology, Neuherberg, Germany.
Anne
A
Zutavern
Peter
P
Rzehak
Inken
I
Brockow
Beate
B
Schaaf
Christina
C
Bollrath
Andrea
A
von Berg
Elke
E
Link
Ursula
U
Kraemer
Michael
M
Borte
Olf
O
Herbarth
H-Erich
HE
Wichmann
Joachim
J
Heinrich
D001424:Bacterial Infections / Q000453:epidemiology* / Q000209:etiology / Q000635:transmission; D002648:Child; D002656:Child Day Care Centers; D002675:Child, Preschool; D005260:Female; D005767:Gastrointestinal Diseases / Q000453:epidemiology* / Q000209:etiology; D005858:Germany / Q000453:epidemiology; D006306:Health Surveys; D006801:Humans; D007223:Infant; D008297:Male; D011446:Prospective Studies; D012141:Respiratory Tract Infections / Q000453:epidemiology* / Q000209:etiology / Q000635:transmission; D012307:Risk Factors; D011795:Surveys and Questionnaires; D014777:Virus Diseases / Q000453:epidemiology* / Q000209:etiology / Q000635:transmission