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Perinatal and early life factors and asthma control among preschoolers: a population-based retrospective cohort study
Linn E Moore1, Jesus Serrano-Lomelin2, Rhonda J Rosychuk1
1Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada.
Insights
Preventing poor childhood asthma control is crucial. Perinatal and early-life factors like prenatal antibiotics, C-sections, and gestational diabetes are linked to partly or uncontrolled asthma in young children.
Area of Science:
- Pediatric Pulmonology
- Perinatal Medicine
- Epidemiology
Background:
- Childhood asthma control is vital for long-term respiratory health.
- Identifying early risk factors can inform preventative strategies.
- Perinatal and early-life exposures are implicated in asthma development and control.
Purpose of the Study:
- To evaluate associations between perinatal and early-life factors and early childhood asthma control.
- To identify specific risk factors contributing to partly or uncontrolled asthma in preschoolers.
- To inform public health initiatives aimed at improving asthma outcomes in children.
Main Methods:
- Retrospective cohort study using administrative health data from mothers and children (born 2010-2012) in Alberta, Canada.
- Included children diagnosed with asthma before age 5, assessing asthma control within 2 years post-diagnosis.
- Multinomial logistic regression analyzed associations between perinatal/early-life factors and asthma control levels (controlled, partly controlled, uncontrolled).
Main Results:
- Of 7206 preschoolers with asthma, 52% had controlled, 37% partly controlled, and 12% uncontrolled asthma.
- Factors associated with partly controlled asthma included prenatal antibiotics, smoking, C-section delivery, summer birth, and early respiratory hospitalizations.
- Gestational diabetes, C-section delivery, antibiotics, and early respiratory hospitalizations were linked to uncontrolled asthma.
Conclusions:
- Maternal and early-life factors such as antibiotic use, gestational diabetes, smoking, C-section delivery, summer birth, and respiratory hospitalizations are associated with poor asthma control in children.
- These findings highlight the critical role of perinatal health and early-life exposures in lung development and disease programming.
- Interventions targeting these modifiable risk factors during pregnancy and early childhood may improve asthma control outcomes.
Background:
Preventing poor childhood asthma control is crucial for short-term and long-term respiratory health. This study evaluated associations between perinatal and early-life factors and early childhood asthma control.
Methods:
This retrospective study used administrative health data from mothers and children born 2010-2012 with a diagnosis of asthma before age 5 years, in Alberta, Canada. The outcome was asthma control within 2 years after diagnosis. Associations between perinatal and early-life factors and risk of partly and uncontrolled asthma were evaluated by multinomial logistic regression.
Results:
Of 7206 preschoolers with asthma, 52% had controlled, 37% partly controlled and 12% uncontrolled asthma 2 years after diagnosis. Compared with controlled asthma, prenatal antibiotics (adjusted risk ratio (aRR): 1.19; 95% CI 1.06 to 1.33) and smoking (aRR: 1.18; 95% CI 1.02 to 1.37), C-section delivery (aRR: 1.11; 95% CI 1.00 to 1.25), summer birth (aRR: 1.16; 95% CI 1.00 to 1.34) and early-life hospitalisation for respiratory illness (aRR: 2.24; 95% CI 1.81 to 2.76) increased the risk of partly controlled asthma. Gestational diabetes (aRR: 1.41; 95% CI 1.06 to 1.87), C-section delivery (aRR: 1.18; 95% CI 1.00 to 1.39), antibiotics (aRR: 1.32; 95% CI 1.08 to 1.61) and hospitalisation for early-life respiratory illness (aRR: 1.65; 95% CI 1.19 to 2.27) were associated with uncontrolled asthma.
Conclusion:
Maternal perinatal and early-life factors including antibiotics in pregnancy and childhood, gestational diabetes, prenatal smoking, C-section and summertime birth, and hospitalisations for respiratory illness are associated with partly or uncontrolled childhood asthma. These results underline the significance of perinatal health and the lasting effects of early-life experiences on lung development and disease programming.
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