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Maternal and neonatal risk factors of asthma in children: Nationwide population based study
Chuang-Ming Wang1, Shun-Ting Yang1, Cheng-Chia Yang2
1Department of Pediatrics, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chia-Yi City 60002, Taiwan.
Insights
Maternal and neonatal factors influence childhood asthma development. Identifying distinct risk factors for transient early, persistent, and late-onset asthma is crucial for early diagnosis and treatment.
Area of Science:
- Pediatric Allergy and Immunology
- Perinatal Medicine
- Epidemiology
Background:
- Previous studies suggest perinatal factors contribute to childhood asthma.
- Investigating specific maternal and neonatal risk factors for distinct asthma phenotypes is needed.
Purpose of the Study:
- To identify maternal and neonatal risk factors associated with three childhood asthma phenotypes: transient early asthma, persistent asthma, and late-onset asthma.
- Utilize data from Taiwan's Maternal and Child Health Database (TMCHD) and National Health Insurance Research Database (NHIRD).
Main Methods:
- Linked TMCHD and NHIRD data from 2004-2008.
- Defined three asthma phenotypes: transient early, persistent, and late-onset asthma.
- Employed multivariate logistic regression analysis to identify risk factors, adjusting for covariates.
Main Results:
- Identified maternal risk factors (Cesarean section, maternal asthma, allergic rhinitis, premature rupture of membranes) and neonatal risk factors (male gender, gestational age 29-37 weeks, ventilator/antibiotic use, allergic rhinitis, atopic dermatitis).
- Twins and premature birth (28 weeks or less) were linked to transient early and persistent asthma.
- Triplets and above were associated with transient early asthma.
Conclusions:
- Different asthma phenotypes possess unique risk factor profiles.
- Early identification of these distinct risk factors is essential for timely diagnosis and effective treatment strategies.
Background:
Small population group-based cohorts have found that perinatal factors may contribute to the development of asthma in children. We aimed to investigate maternal and neonatal risk factors for the asthma phenotypes using two databases from the Taiwan's Maternal and Child Health Database (TMCHD) and the National Health Insurance Research Database (NHIRD).
Methods:
Perinatal data was obtained from 2004 to 2008 in the TMCHD and linked the NHIRD to obtain relevant medical information regarding maternal and neonatal risk factors of three asthma phenotypes which were identified as transient early asthma, persistent asthma, and late-onset asthma. A multivariate logistic regression analysis was conducted to adjust for covariates.
Results:
The percentage of non-asthmatic patients was 77.02% and asthmatic (transient early asthma, late onset asthma, and persistent asthma) patients were 8.96%, 11.64%, and 2.42%, respectively. Maternal risk factors-including Cesarean section, maternal asthma, maternal allergic rhinitis (AR), and premature rupture of membranes-and neonatal risk factors, such as male gender, gestational age 29-37 weeks, ventilator use, antibiotics use, AR, and atopic dermatitis, were associated with the development of these three asthma phenotypes. Twins and a gestational age of 28 weeks or less premature were associated with the development of transient early asthma and persistent asthma, but not late onset asthma. Triplets and above were associated with the development of transient early asthma, but not late onset or persistent asthma.
Conclusion:
Various asthma phenotypes have different risk factors; therefore, their distinct risk factors should be identified in order to early diagnosis and treatment.
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