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Is parent-child bed-sharing a risk for wheezing and asthma in early childhood?
Maartje P C M Luijk1, Agnes M M Sonnenschein-van der Voort2, Viara R Mileva-Seitz3
1School of Pedagogical and Educational Sciences, Erasmus University Rotterdam, Rotterdam, The Netherlands The Generation R Study Group, Erasmus University Medical Center, Rotterdam, The Netherlands luijk@fsw.eur.nl.
Insights
Parent-infant bed-sharing in toddlerhood, not infancy, is linked to a higher risk of childhood asthma. This finding suggests bed-sharing timing is crucial for asthma development.
Area of Science:
- Pediatric respiratory health
- Environmental influences on asthma
- Childhood epidemiology
Background:
- Household crowding is a known risk factor for pediatric respiratory infections, potentially exacerbating asthma symptoms.
- The hygiene hypothesis suggests crowding may offer protection against asthma, creating conflicting perspectives.
- Parent-infant bed-sharing represents a significant aspect of household crowding, necessitating investigation into its specific role in asthma development.
Purpose of the Study:
- To investigate the association between parent-infant bed-sharing and the risk of developing wheezing and asthma in young children.
- To differentiate the impact of bed-sharing at different developmental stages (infancy vs. toddlerhood) on asthma risk.
- To explore potential causal relationships between bed-sharing and asthma using longitudinal data.
Main Methods:
- A population-based prospective cohort study involving 6160 participants.
- Assessment of bed-sharing practices at 2 and 24 months of age.
- Longitudinal tracking of wheezing from 1 to 6 years and asthma diagnosis at 6 years, analyzed using generalized estimating equation models.
Main Results:
- No significant association was found between bed-sharing in early infancy and subsequent wheezing or asthma diagnosis.
- Bed-sharing in toddlerhood (24 months) was positively associated with an increased risk of wheezing (OR 1.42) and asthma (OR 1.57) at 6 years of age.
- Cross-lagged modeling indicated that toddlerhood bed-sharing predicted later wheezing, rather than the reverse.
Conclusions:
- Bed-sharing during toddlerhood, but not infancy, is associated with an elevated risk of asthma in later childhood.
- The timing of parent-infant bed-sharing appears critical in its relationship with asthma development.
- Further research is warranted to elucidate the specific mechanisms underlying the association between toddlerhood bed-sharing and increased asthma risk.
Abstract:
Household crowding can place young children at risk for respiratory infections which subsequently provoke asthma symptoms. However, crowding might also protect against asthma, in accordance with the hygiene hypothesis. We tested if parent-infant bed-sharing, an important dimension of household crowding, increases or decreases the risk for asthma. In a population-based prospective cohort (N = 6160) we assessed bed-sharing at 2 and 24 months; wheezing between 1 and 6 years of age; and asthma at 6 years of age. Generalised estimating equation models were used to assess repeated measures of wheezing and asthma. We found no association between bed-sharing in early infancy and wheezing or diagnosis of asthma. By contrast, we found a positive association between bed-sharing in toddlerhood and both wheezing (OR 1.42, 95% CI 1.15-1.74) and asthma (OR 1.57, 95% CI 1.03-2.38). Wheezing was not associated with bed-sharing when using cross-lagged modelling. This study suggests that bed-sharing in toddlerhood is associated with an increased risk of asthma at later ages, and not vice versa. Further studies are needed to explore the underlying causal mechanisms.
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