Low Cord Blood Pneumococcal Immunoglobulin G (IgG) Antibodies Predict Early Onset Acute Otitis Media in Infancy

Abstract

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.

Morbidade respiratória em crianças fumantes passivas

“…A literatura tem mostrado que, das manifestações otorrinolaringológicas, as otites média, aguda ou crônica são as principais queixas das crianças relacionadas à exposição ambiental do cigarro (21,24,(39)(40)(41) . É importante salientar que o critério adotado neste estudo foi um diagnóstico "referido" e, para maior confiabilidade, foi decidido que apenas os casos confirmados por médicos seriam considerados como portadores da doença.…”

“…Cinco estudos recentes realizados, respectivamente, no Canadá (21) , Suécia (22) , Malásia (23) e EUA (Minnesota (24) e Pensilvânia (25) ), apresentaram dados mostrando associação entre otite média, aguda ou crônica e fumo dos pais.…”

Vaccination and Otitis media

“…A pneumococcal polysaccharide vaccine given during pregnancy could induce protecting antibodies detectable in the newborn for some months [56][57][58]. This approach might be of value in trying to prevent early-onset AOM, which possibly may trigger a child to have recurrent attacks of AOM [59].…”

Parental Smoking and Middle Ear Disease in Children: A Review of the Evidence

“…One reported that adjustment had the effect of increasing the excess risk, but the opposite effect was reported by another, although it should be noted that the adjusted relative risks in this study [31] were presented for two separate age groups, while the unadjusted relative risk was based on the two age groups combined. The failure of the 3 other studies [14,36,46] which presented adjusted relative risks to give AOM = Acute otitis media; ROM = recurrent otitis media; OME = otitis media with effusion; POME = persistent otitis media with effusion; UMED = unspecified middle ear disease.…”

“…Three studies [6,8,15] stated that parental smoking habits were recorded at the beginning of the study period only, 4 studies [4,33,40,53] recorded parental smoking habits at the end of the study period only, 1 study [43] collected information at the beginning or at the end of the study only, 1 study [32] collected information at the beginning of the study or at the birth of the child, while in 5 other studies [12,22,35,51,56], the time at which the information was collected was not stated. The remaining studies [10,13,18,21,24,27,34,46,47,55,58] recorded parental smoking habits throughout the study period.…”