The Impact of Milk Protein Allergy on Pediatric Otitis Media Incidence.

Abstract

Otitis media (OM) is among the most prevalent infections in children. This study aims to investigate the correlation between milk protein allergy (MPA) and the incidence of OM in children. Patients aged 2-17 years were identified in the TriNetX United States database and divided into two cohorts based on the presence or absence of MPA (ICD-10-CM code Z91.011). Propensity score matching was employed to balance demographic and clinical characteristics including age, sex, race, and ethnicity. The primary outcome was the incidence of OM, including acute otitis media (AOM), otitis media with effusion (OME), and chronic suppurative otitis media (CSOM) (ICD-10-CM codes H66, H65, and H66.3, respectively). Secondary outcomes included the number of OM instances per patient. 10,726,154 children were included. After propensity score matching, the final cohorts included 57,531 patients with a mean age of 4.0 years (SD = 3.5). The incidence of OM was significantly higher in the MPA cohort (N = 20,276, 35.2%) compared to the non-MPA cohort (N = 17,143, 29.8%: OR = 1.28, 95% CI = 1.25-1.31, p < 0.001). When stratified by OM type, all types of OM were found to be more common in the MPA cohort compared to the non-MPA cohort (p < 0.001 for all). This study demonstrates a significant association between MPA and an increased risk of OM in pediatric patients. These findings emphasize the importance of early diagnosis and dietary management of MPA to mitigate the risk of OM. Comprehensive care, including tailored preventive strategies, could reduce the burden of OM and improve long-term outcomes for children with MPA.