Recurrent otitis media with effusion in preterm infants with histologic chorioamnionitis — A 3 years follow-up study

BackgroundRecurrent otitis media with effusion (OME) is a leading cause of acquired hearing loss in childhood. Histological chorioamnionitis (HCA) is an important cause of preterm delivery and neonatal morbidity and mortality. Here, we tested the hypothesis of an association between recurrent OME during the first 3 years of life and HCA in very low birth weight (VLBW) infants.MethodsA total of 110 randomly selected VLBW preterm newborns with HCA and 135 gestational age and gender-matched, HCA-negative VLBW infants were evaluated prospectively during the first 3 years of life for the presence of OME, as diagnosed on the basis of otoscopy, type B or C tympanogram, ipsilateral absence of transient evoked otoacoustic emissions responses, and ipsilaterally increased threshold at diagnostic auditory brain responses evaluation. Potential risk factors for OME were also examined in the two groups.ResultsThe HCA-positive infants showed a ~ six times higher frequency of recurrent OME (P < 0.0001), increased frequency (> 5/yr) of clinical otitis media episodes (P = 0.000020), ~ five times higher frequency of adenoid hypertrophy (P < 0.00001), a significant seasonal pattern of birth with autumn predominance (P < 0.00001), and the first OME occurred earlier (P < 0.0001), as compared to the HCA-negative counterparts. Recurrent OME was significantly associated with HCA (O.R. = 17.76, 95% CI: 8.98–35.13, P < 0.00001), adenoid hypertrophy (O.R. = 9.96, 95% CI: 5.17–19.18, P < 0.00001), frequency of acute otitis episodes > 5/yr (O.R. = 8.91, 95% CI: 1.96–40.41, P = 0.0005), and birth in autumn (O.R. = 5.58, 95% CI: 2.79–11.12, P < 0.00001).ConclusionsThese findings indicate that HCA is a previously unrecognized risk factor for the development of recurrent bilateral OME in VLBW preterm infants during the first 3 years of life.