Influência dos hábitos de sucção deletérios na ocorrência de otite média em crianças: revisão sistemática e meta-análise

Abstract

Otitis media is a highly prevalent disease during childhood, that may result in sequelae to the child's hearing, speech and learning. Deleterious sucking habits, such as bottle feeding, pacifier use and finger sucking, have been pointed out by some authors as one of the risk factors for this condition. However, there are still divergences in the literature about such risk factors for otitis media and. Therefore, this study aimed to carry out a systematic review of literature and meta-analysis to assess the influence of deleterious sucking habits on the occurrence of otitis media in children. This review was reported according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) and was registered in the PROSPERO platform (CRD42020197162). A bibliographic search was performed in six databases (Web of Science, Cochrane Library, LILACS, Scopus, MEDLINE via PubMed, and EMBASE) and in grey literature. The titles and abstracts were analyzed by two reviewers independently, and the selected articles were read in full. After reading the full text, articles that met the eligibility criteria were included in the study and extracted and synthesised their data. The Joanna Briggs Institute Critical Appraisal Tool was used to assess the risk of bias in the included studies, and the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) tool was used to assess the certainty of evidence. A meta-analysis was performed using the Review Manager software to synthesize the odds ratio (OR) of those studies that presented methodological homogeneity. Searches identified 2170 results, after removing duplicates, 863 studies were found. Thirty-four studies were included in this review and, among them, ten were included in the meta-analysis. The results of the metaanalysis showed that children who used a pacifier were 1.13 times more likely to have otitis media (CI=1.03–1.240, I 2=9%). However, meta-analyses showed no difference for otitis media between children who were or were not bottle fed (OR=0.83; CI=0.59– 1.17; I 2=35%). Most studies have not shown an association between fingersucking and otitis media, but a meta-analysis was not possible. The risk of bias of the studies varied from low to high. The certainty of collected evidence was very low for pacifier and bottle feeding. In conclusion, children using pacifier are more likely to have otitis media. However, this result must be considered with caution due to the very low certainty of evidence.