Hospitalisation with otitis media in early childhood and cognitive function in young adult life: a prevalence study among Danish conscripts

BMC Pediatrics

Mette Nørgaard¹  Niels Fisker²  Rikke Beck Nielsen¹  Marie Mortensen¹ 

[1] Department of Clinical Epidemiology, Aarhus University Hospital, Olof Palmes Allé 43-45, 8200, Aarhus N, Denmark;H.C. Andersen Children’s Hospital, Odense University Hospital, Sdr. Boulevard 29, 5000, Odense C, Denmark

关键词: Hearing impairment;    Educational level;    Cognitive function;    Otitis media;   

Others  :  1164282
DOI  :  10.1186/1471-2431-13-8

 received in 2012-07-06, accepted in 2013-01-11,  发布年份 2013

【 摘 要 】

Background

Otitis media (OM) is a very common condition in children and occurs during years that are critical to the development of learning, literacy, and math skills. Therefore, among a large cohort of Danish conscripts, we aimed to examine the association between hospitalisation with OM in early childhood and cognitive function and educational level in early adulthood.

Methods

We conducted a population-based prevalence study using linked data from healthcare databases and conscription records of Danish men born between 1977 and 1983. We identified all hospitalisations with OM before 8 years of age. Cognitive function was measured by the Boerge Prien validated group intelligence test (Danish Børge Prien Prøve, BPP). We adjusted for potential confounders with and without stratification by hearing impairment. Furthermore, we examined the association between hospitalisation with OM and the prevalence of having achieved a General Certificate of Secondary Education (GCSE), stratified by quartiles of BPP scores.

Results

Of the 18 412 eligible conscripts aged 18–25 years, 1000 (5.5%) had been hospitalised with OM before age 8. Compared with conscripts without such a record, the adjusted prevalence ratio (PR) for a BPP score in the bottom quartile was 1.20 (95% confidence interval [CI]: 1.09–1.33). There was no major difference in the proportion of men with a GCSE and those without among those hospitalised with OM in early childhood. For men in the bottom and upper quartiles of BPP scores, the PRs for early childhood hospitalisation with OM were 0.89 (95% CI: 0.59–1.33) and 0.96 (95% CI, 0.88–1.05), respectively. Among men with severe hearing impairment, the proportion with a BPP score in the bottom quartile did not differ between those with and without an OM hospitalisation [PR = 1.01 (95% CI: 0.78–1.34)].

Conclusions

Overall, we found that hospitalisation with OM in early childhood was associated with a slightly lower cognitive function in early adulthood. Hospitalisation for OM did not seem to influence the prevalence of GSCE when level of BPP was taken into account.

【 授权许可】

   
2013 Mortensen et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

【 参考文献 】

• [1]Teele DW, Klein JO, Rosner B: Epidemiology of otitis media during the first seven years of life in children in greater Boston: a prospective, cohort study. J Infect Dis 1989, 160(1):83-94.
• [2]Rovers MM: The burden of otitis media. Vaccine 2008, 26(Suppl 7):G2-G4.
• [3]Hansen MP, Jarbol DE, Gahrn-Hansen B, Depont Christensen R, Munck A, Ellegaard Trankjaer Ryborg C, et al.: Treatment of acute otitis media in general practice: quality variations across countries. Fam Pract 2012, 29(1):63-68.
• [4]Roberts JE, Burchinal MR, Zeisel SA: Otitis media in early childhood in relation to children's school-age language and academic skills. Pediatrics 2002, 110(4):696-706.
• [5]Monasta L, Ronfani L, Marchetti F, Montico M, Vecchi Brumatti L, Bavcar A, Grasso D, Barbiero C, Tamburlini G: Burden of disease caused by otitis media: systematic review and global estimates. PLoS One 2012, 7(4):e36226.
• [6]Gravel JS, Wallace IF, Ruben RJ: Auditory consequences of early mild hearing loss associated with otitis media. Acta Otolaryngol 1996, 116(2):219-221.
• [7]Colletti L, Mandala M, Zoccante L, Shannon RV, Colletti V: Infants versus older children fitted with cochlear implants: performance over 10 years. Int J Pediatr Otorhinolaryngol 2011, 75(4):504-509.
• [8]Carney AE, Moeller MP: Treatment efficacy: hearing loss in children. J Speech Lang Hear Res 1998, 41(1):S61-S84.
• [9]Roberts JE, Rosenfeld RM, Zeisel SA: Otitis media and speech and language: a meta-analysis of prospective studies. Pediatrics 2004, 113(3 Pt 1):e238-e248.
• [10]Bennett KE, Haggard MP, Silva PA, Stewart IA: Behaviour and developmental effects of otitis media with effusion into the teens. Arch Dis Child 2001, 85(2):91-95.
• [11]Zumach A, Gerrits E, Chenault M, Anteunis L: Long-term effects of early-life otitis media on language development. J Speech Lang Hear Res 2010, 53(1):34-43.
• [12]Grievink EH, Peters SA, van Bon WH, Schilder AG: The effects of early bilateral otitis media with effusion on language ability: a prospective cohort study. J Speech Hear Res 1993, 36(5):1004-1012.
• [13]Johnson DL, Swank PR, Owen MJ, Baldwin CD, Howie VM, McCormick DP: Effects of early middle ear effusion on child intelligence at three, five, and seven years of age. J Pediatr Psychol 2000, 25(1):5-13.
• [14]Paradise JL, Dollaghan CA, Campbell TF, Feldman HM, Bernard BS, Colborn DK, Rockette HE, Janosky JE, Pitcairn DL, Sabo DL, Kurs-Lasky M, Smith CG: Language, speech sound production, and cognition in three-year-old children in relation to otitis media in their first three years of life. Pediatrics 2000, 105(5):1119-1130.
• [15]Welch D, Dawes P: No negative outcomes of childhood middle ear disease in adulthood. Laryngoscope 2007, 117(3):466-469.
• [16]Lynge E, Sandegaard JL, Rebolj M: The Danish National Patient Register. Scand J Public Health 2011, 39(7 Suppl):30-33.
• [17]Frank L: Epidemiology, When an entire country is a cohort. Science 2000, 287(5462):2398-2399.
• [18]Kjøller M, Rasmussen NK: Danish Health and Morbidity Survey 2000…& trends since 1987. Denmark, Copenhagen: National Institute of Public Health; 2002.
• [19]Mortensen EL, Reinisch M, Teasdale TW: Intelligence as measured by the WAIS and military draft board group test. Scand J Psychol 1990, 31:315.
• [20]Knudsen LB, Olsen J: The Danish Medical Birth Registry. Dan Med Bull 1998, 45(3):320-323.
• [21]Military conscription board: Annex to the military conscription board's circular of 1 July 1985 of the procedures for conscription examination etc. Denmark, Copenhagen; 1985.
• [22]McNutt LA, Wu C, Xue X, Hafner JP: Estimating the relative risk in cohort studies and clinical trials of common outcomes. Am J Epidemiol 2003, 157(10):940-943.
• [23]Marsal K, Persson PH, Larsen T, Lilja H, Selbing A, Sultan B: Intrauterine growth curves based on ultrasonically estimated foetal weights. Acta Paediatr 1996, 85(7):843-848.
• [24]Schafer L: Joseph: Analysis of incomplete multivariate data. New York: Kluwer Academic Publishers Group; 1997.
• [25]Klebanoff MA, Cole SR: Use of multiple imputation in the epidemiologic literature. Am J Epidemiol 2008, 168(4):355-357.
• [26]Ehrenstein V, Pedersen L, Grijota M, Nielsen GL, Rothman KJ, Sorensen HT: Association of Apgar score at five minutes with long-term neurologic disability and cognitive function in a prevalence study of Danish conscripts. BMC Pregnancy Childbirth 2009, 9:14. BioMed Central Full Text
• [27]Green J, Wintfeld N: How accurate are hospital discharge data for evaluating effectiveness of care? Med Care 1993, 31(8):719-731.
• [28]Kerschner EJ: Chapter 639- Otitis Media. In Textbook of Pediatrics. 18th edition. Philadelphia: SAUNDERS ELSEVIER; 2007.
• [29]Mortensen EL, Andresen J, Kruuse E, Sanders SA, Reinisch JM: IQ stability: the relation between child and young adult intelligence test scores in low-birthweight samples. Scand J Psychol 2003, 44(4):395-398.
• [30]Engel J, Anteunis L, Volovics A, Hendriks J, Marres E: 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 1999, 47(3):243-251.
• [31]Wolke D, Schmid G, Schreier A, Meyer R: Crying and feeding problems in infancy and cognitive outcome in preschool children born at risk: a prospective population study. J Dev Behav Pediatr 2009, 30(3):226-238.