PASSIVE SMOKE EXPOSURE AND OTITIS-MEDIA IN THE FIRST YEAR OF LIFE

Objective. This study examined, in a health maintenance organization p opulation of children, the associations between parents' smoking and o titis media (OM) in their children while controlling for other known r isk factors. Methods. Healthy newborns (1246) in a large health mainte nance organization were enrolled at birth, and 1013 (81%) were followe d prospectively for the first year of life. Their medical records were reviewed for the diagnosis of otitis media. Information on risk facto rs for recurrent OM (ROM) was collected, including a number of variabl es related to parental smoking. Results. After controlling for other k nown risk factors for ROM including gender, day care, other siblings i n the home, parental history of hay fever, and method of feeding, it w as found that heavy maternal smoking of 20 or more cigarettes per day was a significant risk factor for ROM but not for nonrecurrent otitis. Heavy maternal smoking was associated with a threefold risk for ROM i f the infant weighed less than the mean at birth (3.5 kg) after contro lling for other risk factors. No association was found with paternal s moking. Conclusions. Heavy maternal smoking is a significant risk fact or for ROM in the first year of life. This smoking effect seems to be stronger among infants of lower birth weight.