The association between childhood overweight and obesity and otitis media

Objective: The objective of this study was to examine the association between otitis media and childhood obesity in a population-based sample of elementary school children in the Canadian province of Nova Scotia. Methods: The study design is a prospective cohort study, linking data from a population-based survey of Grade 5 students (aged 10-11 years) in the Canadian province of Nova Scotia in 2003 with Nova Scotia administrative health data. Measured body mass index was used to define weight status based on the age-and gender-specific cut-off points of the International Obesity Task Force. Health administration data for each child was linked via Health Card numbers. The primary outcome was healthcare utilization (physician visits and costs) for suppurative otitis media (International Classification of Diseases [ICD] 9: 382; ICD10: H65-66) with no previous diagnosis of otitis in the last 30 days. Results: Relative to normal weight children, obese children had more healthcare provider contacts for otitis media (adjusted incidence rate ratio 2.03, 95% confidence interval [CI] 1.66-2.49), incurred more costs per otitis media-related visit ($47 vs. $24, P = 0.0001) and had higher odds to have repeated otitis media (adjusted odds ratio 2.27, 95% CI 1.54-3.35). Socioeconomic factors, a history of breastfeeding, presence of an allergic disorder or chronic adenoid/tonsil disorder did not change the association between obesity and otitis media. Conclusion: There is a clear association between childhood obesity and otitis media that cannot be explained by confounding by socioeconomic factors or clinically associated disorders.