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Pre- and perinatal risk factors for asthma in inner city African-American children
J F Oliveti1, C M Kercsmar, S Redline
1Rainbow Babies and Children's Hospital, University Hospitals, Case Western Reserve University, Cleveland, Ohio, USA.
Insights
Pre- and perinatal factors like maternal smoking and lack of prenatal care significantly increase asthma risk in urban children. Early life exposures appear crucial for developing childhood asthma in vulnerable populations.
Area of Science:
- Pediatrics
- Environmental Health
- Epidemiology
Background:
- Childhood asthma is a significant public health concern, particularly in urban settings.
- Identifying modifiable risk factors during the pre- and perinatal periods is crucial for prevention strategies.
Purpose of the Study:
- To investigate the association between pre- and perinatal risk factors and the development of asthma in African-American children.
- To identify key predictors of asthma in a vulnerable urban population.
Main Methods:
- A case-control study was conducted with 262 African-American children (4-9 years old).
- Risk factors were assessed via review of obstetric, perinatal, and pediatric medical records.
- Multiple logistic regression analysis was used to determine independent predictors of asthma.
Main Results:
- Asthmatic children had lower birth weights and gestational ages, and higher rates of neonatal oxygen use.
- Mothers of asthmatic children were more likely to smoke during pregnancy, have inadequate prenatal care, and experience lower weight gain.
- Key predictors included maternal asthma history, lack of prenatal care, bronchiolitis history, positive pressure ventilation at birth, low maternal weight gain, and maternal smoking.
Conclusions:
- Pre- and perinatal exposures are significant risk factors for childhood asthma in inner-city populations.
- Interventions targeting maternal health behaviors and prenatal care may reduce asthma incidence.
Abstract:
The relations between pre- and perinatal risk factors and asthma were investigated using a case-control study of 262 African-American children aged 4-9 years, both asthmatic and nonasthmatic, all of whom resided in a poor urban area and received health care at a local hospital-based clinic. Risk factors were ascertained through review of obstetric, perinatal, and pediatric records. Asthmatic children had significantly lower birth weights and gestational ages than nonasthmatic children and were more likely to have required oxygen supplementation and positive pressure ventilation after birth than nonasthmatics (p < 0.05). The mothers of asthmatic children were more likely to have smoked during pregnancy (50% vs. 27%), to have gained less weight during pregnancy (26.3 pounds (11.9 kg) vs. 34.5 pounds (15.7 kg)), and to have had no prenatal care (12% vs. 2% ) than mothers of nonasthmatic children. Multiple logistic regression demonstrated that the strongest independent predictors of asthma were maternal history of asthma (adjusted odds ratio (OR) = 9,7), lack of prenatal care (OR = 4.7), history of bronchiolitis (OR = 4.7), positive pressure ventilation at birth (OR = 3.3), low maternal weight gain (<20 pounds (<9 kg)) (OR = 3.4), and maternal smoking during pregnancy (OR = 2.8). These data suggest that pre- and perinatal exposures may increase susceptibility to asthma in inner city children.