American Journal of Epidemiology Vol. 145, No. 11: 1048-1056
Copyright © 1997 by The Johns Hopkins University School of Hygiene and Public Health
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Low Cord Blood Pneumococcal Immunoglobulin G (IgG) Antibodies Predict Early Onset Acute Otitis Media in Infancy
1University of Minnesota School of Medicine, Department of Pediatrics Minneapolis, MN
2University of Minnesota School of Medicine, Department of Otolaryngology Minneapolis, MN
3HeatthPartners, Division of Pediatric Medicine Minneapolis, MN
4University of Minnesota, School of Public Health, Division of Biostatistics Minneapolis, MN
5University of Minnesota, Otttis Media Research Center Minneapolis, MN
6Fundacion Valle del Lili Cali, Colombia
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. Am J Epidemiol 1997; 145: 1048-56.
antibodies; infant; newborn; diseases; otitis media; pneumococcal infections; Streptococcus pneumoniae
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