Why are NICU infants at risk for chronic otitis media with effusion?

Newborns in a Neonatal Intensive Care Unit (NICU) and even later have a hig h incidence of otitis media with effusion (OME). It is unclear which aspect s play a role in the incidence of chronic OME during infancy. In order to i nvestigate the effect of nasally-placed tubes, cranial growth, immune syste m, and neuromotor function on the occurrence of chronic OME, 83 NICU patien ts were observed prospectively for middle ear status. Duration and type of treatment with nasal tubes were obtained from the NICU notes. At the NICU, and 1 and 2 years of age the cranial circumference and neuromotor function were assessed. As a proxy for disturbed local immune system parental report s of snoring, mouth breathing and common cold were used. Multivariate analy sis revealed that infants treated with nasotracheal and nasopharyngeal tube s showed a marginally significant increased risk for chronic OME (OR = 3.2 [95% CT 0.5-21.2]). Treatment with nasogastric tubes appeared to have a low er risk for chronic OME (OR = 1.5 [95% CI 0.1-25.1]). No significant effect was found for cranial circumference. Signs of disturbed local immunity dur ing the first 6 months of life (OR = 1.4 [95% CI 0.4-4.7]), as well as impa ired neuromotor function (OR = 1.9 [95% CI 0.5-6.8]), showed also a margina lly significant increased risk for chronic OME. The cohort of NICU patients might be relatively tao small in order to find significant effects. Althou gh the results of this study should be interpreted cautiously, it is sugges ted that nasally-placed tubes for ventilatory assistance, disturbed local i mmunity and impaired neuromotor function are associated with chronic OME. ( C) 2001 Elsevier Science Ireland Ltd. All rights reserved.