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Low Cord Blood Pneumococcal Antibody Concentrations Predict More Episodes of Otitis Media
Eric T. Becken, MD;
Kathleen A. Daly, PhD;
Bruce R. Lindgren, MS;
Mary H. Meland, MD;
G. Scott Giebink, MD
Arch Otolaryngol Head Neck Surg. 2001;127:517-522.
Objective To determine if cord blood anticapsular polysaccharide pneumococcal
IgG antibody concentration was related to the number of otitis media (OM)
and acute OM episodes during the first year of life.
Design Prospective study following infants from birth to 24 months.
Setting Health maintenance organization.
Patients The study population consisted of 415 infants whose mothers volunteered
for the study during pregnancy. Cord blood samples were collected and infants
were followed up for OM in the health maintenance organization. Ninety-seven
percent of the infants were white, 49% male, 3% from households with annual
incomes of less than $20 000, and 30% from households with annual incomes
of more than $60 000.
Main Outcome Measure Number of physician-diagnosed OM episodes, including both OM with effusion
and acute OM, and acute OM episodes from birth to 12 months.
Results With univariate analysis, low cord blood antibody concentrations against
serotypes 3 and 19F predicted more acute OM episodes (P = .04 and P = .05, respectively), and low
antibody concentrations against serotypes 19F and 23F predicted more OM episodes
(P = .04 and P = .05, respectively)
over the first year of life. With Poisson regression, which adjusted for variables
related to the recurrence of OM and having low cord blood antibody concentrations,
serotype 19F remained significantly related to the number of OM episodes (relative
risk for lowest quartiles vs upper 3 quartiles 1.23; 95% confidence interval,
1.02-1.50; P = .03).
Conclusions Low cord blood antibody concentrations to serotype 19F predicted more
OM episodes over the first 12 months of life. These results suggest the potential
benefit of maternal immunization to raise neonatal antipolysaccharide pneumococcal
antibody concentration and delay the onset and reduce the number of OM episodes.
From the University of Minnesota Medical School (Dr Becken), the Otitis
Media Research Center (Drs Becken, Daly, and Giebink), the Departments of
Otolaryngology (Drs Daly and Giebink) and Pediatrics (Dr Giebink), and the
Division of Biostatistics (Mr Lindgren), University of Minnesota School of
Public Health, and HealthPartners Inc (Dr Meland), Minneapolis.
Corresponding author and reprints: Kathleen A. Daly, PhD, Otitis
Media Research Center, MMC 396, University of Minnesota, 420 Delaware St SE,
Minneapolis, MN 55455 (e-mail: dalyx002{at}umn.edu).
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