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Pregnancy exposures and risk of childhood asthma admission in a population birth cohort
Article first published online: 19 SEP 2011
© 2011 John Wiley & Sons A/S
Pediatric Allergy and Immunology
Volume 22, Issue 8, pages 836–842, December 2011
How to Cite
Algert, C. S., Bowen, J. R., Lain, S. L., Allen, H. D., Vivian-Taylor, J. M. and Roberts, C. L. (2011), Pregnancy exposures and risk of childhood asthma admission in a population birth cohort. Pediatric Allergy and Immunology, 22: 836–842. doi: 10.1111/j.1399-3038.2011.01206.x
- Issue published online: 29 NOV 2011
- Article first published online: 19 SEP 2011
- Accepted for publication 25 July 2011
- risk factors
To cite this article: Algert CS, Bowen JR, Lain SL, Allen HD, Vivian-Taylor JM, Roberts CL. Pregnancy exposures and risk of childhood asthma admission in a population birth cohort. Pediatr Allergy Immunol 2011: 22: 836–842.
Background: There is increasing interest in the potential for in utero exposures to affect the risk of asthma. We used population data to explore the associations between perinatal conditions and the risk of hospital admission with asthma between the 2nd and 5th birthday.
Methods: The study population was 240,511 singleton infants born during 2001–2003. Birth records and longitudinally linked hospital admissions were used to identify asthma admissions and to model potential risk factors.
Results: A total of 7245 children (3.0%) had one or more childhood admissions with asthma. In utero infectious exposures associated with childhood asthma were maternal antenatal admission with a urinary tract infection (UTI) [adjusted odds ratio (aOR) = 1.49, 95% confidence interval (1.23–1.79)] and pre-term pre-labor rupture of membranes (PROM) [aOR = 1.23 (1.04–1.45)]. There was no evidence that gestational age at time of first antenatal UTI admission (<28, ≥28 wks) affected the risk of asthma (homogeneity test p = 0.6). Pre-term birth was a risk factor for asthma admission, with the risk decreasing by 5.3% with each extra week of gestation. Autumn and winter conceptions were associated with an increased risk of childhood asthma admission: winter aOR = 1.15 (1.08–1.23), autumn aOR = 1.09 (1.02–1.16).
Conclusions: As in utero exposure to both UTI and PROM carry an increased risk of childhood asthma admission, this suggests that the immune system response generally is the relevant factor rather than a specific organism. The season-associated risk is consistent with early pregnancy exposures such as the winter flu season or low vitamin D.