title: Early-life otitis media and incident atopic disease at school age in a birth cohort.
abstract: BACKGROUND
  Otitis media is a common and costly disease that peaks in early childhood. Recent reviews concluded that the relationship between otitis media and atopy is not well understood, and that further research is warranted.
  
  
  METHODS
  Logistic regression was used to analyze data from a German Birth Cohort (n = 1690; born 1997–1999). Parental questionnaires were used to assess children for physician-diagnosed otitis media throughout the first 2 years of life and for incident atopic disease (asthma, allergic rhinitis, and eczema) during the sixth year of life. Odds ratios were adjusted for gender, older siblings, city, parental education, breast-feeding, and daycare. Parallel analyses were completed for the full birth cohort and for a population subset with atopic mothers.
  
  
  RESULTS
  The adjusted odds of asthma were elevated for children with early-life otitis media, but were statistically significant only for those children with at least 3 episodes (adjusted odds ratio: 4.26 [95% confidence interval: 1.34–13.6]). Associations between early-life otitis media and allergic rhinitis were largely inconsistent. There was a positive association between early-life otitis media and late-onset allergic eczema (≥2 episodes: 2.68 [1.35–5.33], ≥3 episodes: 3.84 [1.80–8.18]). Similar results were found for the maternal atopy subgroup but with greater effect estimates.
  
  
  CONCLUSIONS
  Children diagnosed with otitis media during infancy were at greater risk for developing late-onset allergic eczema and asthma during school age, and associations were stronger for frequent otitis. These results indicate that frequent otitis media during infancy may predispose children to atopic disease in later life.
authors.affiliation: Institute of Epidemiology, German Research Centre for Environmental Health, Neuherberg, Germany.
authors.forename: Elaina A
authors.initials: EA
authors.lastname: MacIntyre
authors.forename: Chih-Mei
authors.initials: CM
authors.lastname: Chen
authors.forename: Olf
authors.initials: O
authors.lastname: Herbarth
authors.forename: Michael
authors.initials: M
authors.lastname: Borte
authors.forename: Beate
authors.initials: B
authors.lastname: Schaaf
authors.forename: Ursula
authors.initials: U
authors.lastname: Krämer
authors.forename: Andrea
authors.initials: A
authors.lastname: von Berg
authors.forename: H-Erich
authors.initials: HE
authors.lastname: Wichmann
authors.forename: Joachim
authors.initials: J
authors.lastname: Heinrich
mesh_terms: D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D005858:Germany; D006801:Humans; D006969:Hypersensitivity, Immediate / Q000453:epidemiology*; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D010033:Otitis Media / Q000453:epidemiology*; D010290:Parents; D011795:Surveys and Questionnaires