Prognostic factors for persistent otitis media with effusion in infants

Objective: To study prognostic factors for persistent otitis media with eff usion (OME) in a birth cohort of 30 099 children born in the eastern part o f 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 birt hday and were subsequently diagnosed with bilateral OME during 3 of the 4 b imonthly visits to an ear, nose, and throat (ENT) department (n = 372). The persistent cases were compared with 3 referent groups: (1) all the childre n who attended the first of 3 hearing tests; (2) all the children of the bi rth cohort who were referred to an ENT department after the third hearing t est; 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 w ere taken as referents, persistent OME was associated with upper respirator y 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 cen ter was associated with persistent OME. When the children diagnosed with bi lateral OME during the first visit to an ENT department were taken as refer ents, 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.