Abstract
It has recently been hypothesised that large amounts of amniotic fluid cellular content (AFCC) in the middle ear may lead to chronic inflammation and predispose young children to recurrent middle ear infections. Because children born with meconium-stained amniotic fluid (MSAF) have higher AFCC in the middle ear, we performed a retrospective cohort study to determine whether children born with MSAF had a higher risk of OM during infancy. Children born between May 1998 and April 2000 formed two groups based on the absence or presence of MSAF at birth as documented in the hospital birth records. In April 2002, home visits were made to take tympanometric measurements and administer a questionnaire on OM history and possible confounders. Logistic regression models were constructed to assess odds ratios (OR) as a measure of the effect of MSAF on OM and to adjust for potential confounders. There were no differences in the point prevalence of a type-B tympanogram at the home visit (OR 0.81; 95% confidence interval: 0.38–1.76). Also, no statistically significant association was found between the proportion of children with OM diagnosed in the 1st year of life (OR 0.86, 95% confidence interval: 0.27–2.73) and in the proportion of children that had ever been diagnosed with OM (OR 0.91, 95% confidence interval: 0.40–2.91). It can be concluded that children born with MSAF do not constitute a high-risk group for OM in early childhood. A long-term OM effect, especially in severe MSAF cases, cannot be excluded.
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References
Aschoff L (1897) Die otitis media neonatorium. Ein beitrag zur Entwicklungsgeschichte der Paukenhöhle. Z Ohrenh 312: 295–346
Cantekin E (1983) Algorithm for diagnosis of otitis media with effusion. Ann Otol Rhinol Laryngol 92: 6
Cioce C, Canubi A (1978) L'otite del neonato. Ann Laringol Otol Rinol Faringol 76: 571–578
Eavey RD (1993) Abnormalities of the neonatal ear: otoscopic observations, histologic observations, and a model for contamination of the middle ear by cellular contents of amniotic fluid. Laryngoscope 103: 1–31
Engel J, Anteunis L, Volovics A, Hendriks J, Marres E (1999) Prevalence rates of otitis media with effusion from 0 to 2 years of age: healthy-born versus high-risk-born infants. Int J Pediatr Otorhinolaryngol 47: 243–251
Engel J, Anteunis L, Volovics A, Hendriks J, Marres E (1999) Risk factors of otitis media with effusion during infancy. Int J Pediatr Otorhinolaryngol 48: 239–249
Jaber L, Gabriel R, Merlob P (1993) Meconium aspiration and otitis media in children. Eur J Pediatr 152: 164–165
Jerger J (1970) Clinical experience with impedance audiometry. Arch Otolaryngol 92: 311–324
Maw AR (1995) Glue ear in childhood: a prospective study of otitis media with effusion. MacKeith Press, London
Palva T, Northrop C, Ramsay H (1999) Spread of amniotic fluid cellular content within the neonate middle ear. Int J Pediatr Otorhinolaryngol 48: 143–153
Palva T, Northrop C, Ramsay H (2000) Effect of amniotic fluid cellular content on attic aeration pathways: histologic observations of infants aged 2 to 4 months. Am J Otol 21: 62–70
Palva T, Northrop C, Ramsay H (2001) Foreign body neonatal otitis media in infants. Otol Neurotol 22: 433–443
Piza J, Gonzalez M, Northrop CC, Eavey RD (1989) Meconium contamination of the neonatal middle ear. J Pediatr 115: 910–914
Ramsay H, Palva T, Northrop C (2001) Spread and fate of amniotic fluid cellular content in the middle ear. Acta Otolaryngol 121: 190–193
Uhari M, Mantysaari K, Niemela M (1996) A meta-analytic review of the risk factors for acute otitis media. Clin Infect Dis 22: 1079–1083
Wittmaack K (1918) Über die normale und pathologische Pneumatisation des Schläfenbeines. Gustav Fischer Verlag, pp 37–56
Acknowledgements
We would like to thank Dr. J. M. J. Sporken, gynaecologist, at the Canisius-Wilhelmina Hospital Nijmegen and Dr. A. N. J. A. de Groot, gynaecologist, at the University Medical Centre Nijmegen for their help in selecting the study population. Dr. F.A.M van Balen, general practitioner at the Julius centre for general practice and patient-oriented research, University Medical Centre Utrecht, is acknowledged for providing the Welch Allyn Microtymp. Furthermore, we would like to thank the children and of course their parents for participating in this study.
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Straetemans, M., Schönbeck, Y., Engel, J.A.M. et al. Meconium-stained amniotic fluid is not a risk factor for otitis media. Eur Arch Otorhinolaryngol 260, 432–435 (2003). https://doi.org/10.1007/s00405-003-0601-3
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DOI: https://doi.org/10.1007/s00405-003-0601-3