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Published on: August 7, 2017
The association between substantiated childhood maltreatment, asthma and lung function: A prospective investigation
Amanuel Alemu Abajobir1, Steve Kisely2, Gail Williams1
1Faculty of Medicine, School of Public Health, The University of Queensland, Public Health Building, Herston 4006, Queensland, Australia.
Insights
Childhood maltreatment, especially emotional abuse, is linked to a higher likelihood of developing asthma in adulthood. However, this association did not extend to objective lung function measures in a large Australian birth cohort study.
Area of Science:
- Public Health
- Epidemiology
- Developmental Psychology
Background:
- Asthma development is complex, with multiple potential causal pathways.
- Childhood maltreatment represents early life adversity, potentially impacting long-term health outcomes.
- Investigating the link between childhood adversity and asthma is crucial for public health.
Purpose of the Study:
- To examine if childhood maltreatment is a causal pathway for asthma development.
- To assess the association between childhood maltreatment and physician-diagnosed asthma.
- To evaluate the relationship between childhood maltreatment and objective lung function measures.
Main Methods:
- Prospective Australian birth cohort study (Mater Hospital-University of Queensland Study of Pregnancy) with 3762 participants followed to age 21.
- Self-reported physician-diagnosed asthma and gender- and height-standardized lung function tests were assessed.
- Childhood maltreatment data were linked from child protection services, including substantiated cases from age 0-14.
Main Results:
- Any childhood maltreatment, particularly emotional abuse, was independently associated with self-reported asthma by age 21.
- This association lost significance after adjusting for confounders in neglected children.
- Childhood maltreatment, including multiple events, showed no association with objective lung function measures.
Conclusions:
- Childhood maltreatment, including emotional abuse, is associated with a history of asthma.
- No association was found between childhood maltreatment and objective lung function.
- Further research on childhood maltreatment's impact on lung function using objective measures is warranted, alongside increased awareness of its potential role in asthma development.
Background:
Asthma reflects multiple and likely complex causal pathways. We investigate the possibility that childhood maltreatment is one such causal pathway. Childhood maltreatment can be interpreted as a form of early life adversity and like other life adversities may predict a range of negative health outcomes, including asthma.
Methods:
A total of 3762 young adults (52.63% female) from the Mater Hospital-University of Queensland Study of Pregnancy (MUSP) participated in this study. MUSP is a prospective Australian birth cohort study of mothers consecutively recruited during their first antenatal clinic visit at Brisbane's Mater Hospital from 1981 to 1983. The study followed both mother-child dyads to the age of 21years after birth. Participants reported whether they had been diagnosed by a physician with asthma by the 21-year follow-up. Trained research assistants also performed gender- and height-standardized lung function tests using a Spirobank G spirometer system attached to a laptop computer. We linked this dataset with data obtained from the child protection services and which comprised all substantiated cases of childhood maltreatment in the MUSP cohort. Substantiations of childhood maltreatment included children in an age range of 0-14years.
Results:
The experience of any childhood maltreatment, particularly emotional abuse, was independently associated with self-reported physician-diagnosed asthma by the 21-year follow-up. The association was no longer significant after adjustment for a range of confounders and covariates in neglected children. Childhood maltreatment, including multiple events, was not associated with lung function in adjusted models.
Conclusions:
Childhood maltreatment, including emotional abuse, was associated with lifetime ever asthma. This was in contrast to the absence of an association with objective measures of lung function. More research is indicated on the effect of childhood maltreatment on lung function using objective measures. In the meantime, there should be a greater awareness of the potential impact of childhood maltreatment on the potential to develop asthma, as well as of the possibility that asthma in adulthood may precede childhood maltreatment.
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