Prognostic factors for persistent otitis media with effusion in infants

Objective: To study prognostic factors for persistent otitis media with effusion (OME) in a birth cohort of 30 099 children born in the eastern part of the Netherlands between January 1, 1996, and April 1, 1997. Design: Case-referent study. Subjects: Children who failed a triple hearing test before their first birthday and were subsequently diagnosed with bilateral OME during 3 of the 4 bimonthly visits to an ear, nose, and throat (ENT) department (n = 372). The persistent cases were compared with 3 referent groups: (1) all the children who attended the first of 3 hearing tests; (2) all the children of the birth cohort who were referred to an ENT department after the third hearing test; and (3) all the children who were diagnosed with bilateral OME during the first visit to an ENT department. Results: When all the children who participated in the first hearing test were taken as referents, persistent OME was associated with upper respiratory tract infections, attending a day-care center, having older siblings, and a family history of otitis media. When all the children who were referred to an ENT department were taken as referents, only attending a day-care center was associated with persistent OME. When the children diagnosed with bilateral OME during the first visit to an ENT department were taken as referents, no prognostic factors were found for OME persistence. Conclusion: When a child is referred early, an otolaryngologist can ask the parent about the presence of prognostic factors to decide which policy to follow.