Perinatal factors and the risk of asthma in childhood--a population-based register study in Finland
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Published on: August 7, 2017
Johanna Metsälä1, Annamari Kilkkinen, Minna Kaila
1Department of Health Promotion and Chronic Disease Prevention, National Public Health Institute, Helsinki, Finland. johanna.metsala@ktl.fi
Insights
Perinatal factors like maternal asthma and cesarean birth increase childhood asthma risk. Etiology differs for early-onset versus late-onset asthma, highlighting distinct developmental pathways.
Area of Science:
- Pediatrics
- Epidemiology
- Environmental Health
Background:
- Asthma is a common chronic respiratory disease in children.
- Understanding the role of perinatal factors in asthma development is crucial for prevention strategies.
Purpose of the Study:
- To investigate the association between perinatal factors and the risk of childhood asthma.
- To explore potential differences in etiology between early-onset and late-onset asthma.
Main Methods:
- Nested case-control study using Finnish population-based registers.
- Identified 21,038 children with asthma and matched them with controls.
- Analyzed perinatal factors using conditional logistic regression.
Main Results:
- Maternal asthma, young maternal age, smoking, previous miscarriages, high parity, cesarean section, low gestational age, and low ponderal index were linked to increased asthma risk before age 3.
- For asthma diagnosed at age 3+, maternal asthma, low gestational age, and low ponderal index increased risk, while high parity decreased it.
Conclusions:
- Perinatal factors significantly influence childhood asthma development.
- Distinct perinatal risk profiles may exist for early- versus late-onset childhood asthma.
Abstract:
The aim of the study was to assess whether perinatal factors are associated with the risk of asthma in childhood in a register-based, nested case-control study in Finland. All children born between January 1, 1996, and April 30, 2004, who were entitled to a special reimbursement for antiasthmatic drugs (i.e., had diagnosed asthma by 2006 and had purchased inhaled corticosteroids or montelukast at least once), were identified (n = 21,038). For each case, one matched control child was selected. The associations between perinatal factors, derived from the Finnish Medical Birth Register, and the risk of asthma were analyzed by conditional logistic regression. In the final multivariate model, maternal asthma, young age, smoking, previous miscarriages, and a high number of previous deliveries, as well as cesarean section, low gestational age, and low ponderal index, were associated with an increased risk of asthma in children diagnosed before the age of 3 years. Among children diagnosed at the age of 3 years or later, maternal asthma, low gestational age, and low ponderal index were associated with an increased risk, and a high number of previous deliveries was associated with a decreased risk of asthma. In conclusion, perinatal factors play a role in the development of asthma in childhood, but the etiology may differ in early and late-onset asthma.
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