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Vol. 60. Issue 2.
Pages 133-138 (1 February 2004)
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Vol. 60. Issue 2.
Pages 133-138 (1 February 2004)
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Incidencia, contaminación ambiental y factores de riesgo de otitis media aguda en el primer año de vida: estudio prospectivo
Incidence, air pollution and risk factors of acute otitis media in the first year of life. a prospective study
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M.aJ. Cáceres Udinaa, J.A. Álvarez Martínezb, J. Argente del Castilloc, M.aA. Chumilla Valderasd, E. Fernández Álvareze, A. Garrido Romeraf, F. Sánchez Gascóng, L. García-Marcosh,
Corresponding author
lgmarcos@um.es

Correspondencia: Unidad de Investigación. Pl. San Agustín, 3. 30201 Cartagena. España
a Centros de Salud Mazarrón, Facultad de Medicina de Murcia y Unidad de Investigación Cartagena. España
b Centros de Salud Santa Lucía, Facultad de Medicina de Murcia y Unidad de Investigación Cartagena. España
c Centros de Salud El Algar, Facultad de Medicina de Murcia y Unidad de Investigación Cartagena. España
d Centros de Salud Los Dolores, Facultad de Medicina de Murcia y Unidad de Investigación Cartagena. España
e Centros de Salud San Antón, Facultad de Medicina de Murcia y Unidad de Investigación Cartagena. España
f Centros de Salud Cartagena Casco, Cartagena (Murcia)
g U.D. Medicina Interna, Facultad de Medicina de Murcia
h U.D. Pediatría. Facultad de Medicina de Murcia y Unidad de Investigación Cartagena. España
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Antecedentes

Los estudios epidemiológicos sobre la otitis media aguda (OMA) son muy escasos y en España no existe ninguno de tipo prospectivo

Objetivos

Describir la incidencia de la OMA durante el primer año de vida y sus factores de riesgo, con especial atención a la contaminación ambiental

Métodos

Estudio de una cohorte prospectiva de 229 recién nacidos durante el primer año de vida estratificados por zonas de contaminación, seguidos por sus pediatras en el centro de salud. La OMA de definió clínicamente. Se aplicó un cuestionario con los factores de riesgo/protectores, incluyendo sexo, hermanos mayores, hábito de fumar, lactancia materna, nivel socioeconómico, nivel de estudios y situación laboral de la madre

Resultados

La incidencia de episodios de OMA durante el primer año fue del 45 % y la proporción de niños con al menos un episodio fue del 32 %. Los factores de riesgo independientes fueron el sexo varón (odds ratio ajustada [ORa], 2,03; intervalo de confianza del 95 % [IC 95 %], 1,09–3,7) y vivir en una zona contaminada (ORa, 2,01; IC 95 %, 1,05–3,84). Fueron factores protectores independientes nacer en primavera (ORa, 0,41; IC 95 %, 0,19–0,88) y que la madre tuviera al menos estudios primarios (ORa, 0,53; IC 95 %, 0,24–1,15). Los marcadores socioeconómicos indicaron un menor nivel medio entre las familias cuyos niños tuvieron al menos un episodio de OMA

Conclusiones

La contaminación ambiental y el bajo nivel socioeconómico son factores de riesgo de OMA mayores que tener hermanos o que los padres fumen. Un nivel cultural mínimo reduce el riesgo de OMA. Es posible disminuir en parte la incidencia de OMA actuando sobre algunos factores ambientales

Palabras clave:
Otitis media aguda
Epidemiología
Polución atmosférica
Nivel socioeconómico
Factores de riesgo
Niño
Background

Epidemiological studies of acute otitis media (AOM) are scarce and no prospective studies have been performed in Spain

Objectives

To describe the incidence of AOM in the first year of life and its associated risk factors, with special focus on air pollution

Methods

We performed a prospective cohort study of 229 newborn infants during the first year of life stratified by pollution zones, and followed-up by their pediatricians in their health center. AOM was defined on clinical grounds. A questionnaire on risk/protective factors included items on the following: sex, older siblings, smoking, breastfeeding, socioeconomic status, parental education and the mother's occupational status

Results

The incidence of AOM episodes during the first year of life was 45 % and the proportion of children who experienced at least one episode was 32 %. Independent risk factors were male gender (aOR: 2.03; 95 % CI: 1.09–3.7) and living in a polluted area (aOR: 2.01; 95 % CI: 1.05–3.84). Independent protective factors were being born in spring (aOR: 0.41; 95 % CI: 0.19–0.88) and having a mother with at least primary school education (aOR: 0,53; 95 % CI: 0.24–1.15). Socioeconomic markers indicated a lower mean level among families whose children had at least one AOM episode

Conclusions

Air pollution and low socioeconomic status are greater risk factors for AOM than having siblings or parents who smoke. A minimum educational level reduces the risk of AOM. The incidence of AOM could be reduced by modifying certain environmental factors

Key words:
acute otitis media
Epidemiology
Air pollution
Socioeconomic status
Risk factors
Child
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