Low cord blood pneumococcal immunoglobulin G (IgG) antibodies predict early onset acute otitis media in infancy

Juan C. Salazar, Kathleen A. Daly, G. Scott Giebink, Bruce R. Lindgren, Carol L. Liebeler, Mary Meland, Chap T. Le

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29 Scopus citations


Low maternally derived serum immunoglobulin G (IgG) antibodies to Streptococcus pneumoniae capsular polysaccharides (PS) combined with the inability of infants to produce anti-PS antibody may explain onset of otitis media in the first 6 months of life. To explore this relation, cord blood samples were assayed for anti-PS IgG antibodies from 414 of 592 infants enrolled in a study of early onset otitis media between 1991 and 1994. Infants' ears were examined at health supervision and illness visits for the first 6 months of life in a large Minneapolis-St. Paul, Minnesota, health maintenance organization. Antibodies to seven common pneumococcal serotypes (3, 4, 6B, 14, 18C, 19F, and 23F) were measured by enzyme-linked immunoabsorbent assay (ELISA). Cox's regression analysis revealed that among infants with a sibling otitis media history, those with low concentrations of type 14 or 19F anti-PS cord blood antibody had earlier otitis media onset than those with higher cord blood antibody concentrations (relative risks (RR) (95% confidence intervals (CI)) - 1.77 (1.052.99) and 1.89 (1.11-3.23), respectively). Day care attendance also increased risk (RR - 1.56, 95% CI 0.96-2.52). Breastfeeding, parental smoking, and low anti-PS antibody to pneumococcal serotypes 3, 4, 6B, 18C, and 23F did not significantly affect the risk of early otitis media.

Original languageEnglish (US)
Pages (from-to)1048-1056
Number of pages9
JournalAmerican journal of epidemiology
Issue number11
StatePublished - Jun 1 1997

Bibliographical note

Funding Information:
This work was supported by grant nos. PO1-DCOO133 and R01-DC01242 from the National Institute on Deafness and Other Communication Disorders, the Minnesota Medical Foundation, and the Deafness Research Foundation. Dr. Salazar also received support from the American Legion and Auxiliary Heart Research Fund.


  • Streptococcus pneumoniae
  • antibodies
  • diseases
  • infant
  • newborn
  • otitis media
  • pneumococcal infections


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