Objectives-We examined relationships between otitis media risk factors, sociodemographic characteristics, and maternal knowledge and attitudes and early onset of otitis media.
Methods-Pregnant women from MinnesotaAmerican Indian reservations and an urban clinic were enrolled in our study between 1998 and 2001. Follow-up was performed on enrollees′ infants until the children were aged 2 years. Research nurses collected data by ear examination, from interviews and questionnaires given to enrolled mothers, and otitis media episodes that were abstracted from medical records.Results-Sixty-three percent of infants had experienced an otitis media episode by 6 months of age. Logistic regression analyses showed that maternal otitis media history, infant history of upper respiratory infection, and compliance with study visits were significantly related to early otitis media onset. Although high percentages of infants were exposed to cigarette smoke and other children and were formula fed, these factors were not related to otitis media. Mothers′ prenatal awareness of otitis media risks associated with environmental tobacco smoke exposure and formula feeding did not predict their postpartum behaviors.Conclusions-We found that infant history of upper respiratory infection and maternal otitis media history are risk factors for early otitis media in American Indian infants. Mothers′ prepartum knowledge and attitudes regarding otitis media did not predict their postpartum avoidance of risk behaviors.Requests for reprints should be sent to Kathleen A. Daly, PhD, Department of Otolaryngology, MMC 396, 420 Delaware St SE, Minneapolis, MN 55455 (e-mail: dalyx002@umn.edu. Contributors K. A. Daly originated and supervised the study, participated in developing the algorithm to diagnose otitis media, and wrote the article. P. L. Pirie trained research nurses in interview techniques, designed many of the questions, and reviewed and commented on the article. K. L. Rhodes coordinated the study and reviewed and commented on the article. L. L. Hunter trained the research nurses in tympanometry and hearing screenings, oversaw the interpretation of these tests, and participated in developing the algorithm to diagnose otitis media. C. S. Davey performed the analysis, participated in developing the algorithm to diagnose otitis media, and reviewed and commented on the article.
Human Participant ProtectionThis study was approved by the institutional review boards of the University of Minnesota and the Indian Health Service. A certificate of confidentiality was also obtained from the National Institutes of Health to protect the confidentiality of sensitive data collected as part of the study. Women or their legal guardians provided written informed consent. Otitis media (OM) affects nearly all preschool children, and onset in the first few months of life predicts later chronic and recurrent OM. 1-4 Data from the Indian Health Service (IHS) and the National Center for Health Statistics revealed that, during the 1990s, OM-associated outpatie...