Familial Risk of Asthma for Children with Affected Family Members in Multiple Generations

Abstract

Background: While a parental history of asthma has been widely reported as a risk factor for childhood asthma, less is known about the impact of multigenerational family history of asthma on the occurrence of asthma in children. Methods: From 2012 to 2013, a cross-sectional study was carried out in seven Chinese cities. Participants were randomly selected from 94 middle schools, elementary schools and kindergartens. Questionnaires, from which information on asthma, environmental exposure and family members (parents, paternal grandparents and maternal grandparents) affected by asthma were obtained, were completed by the children's parents or guardians. Two-level logistic regressions were used to assess hereditary patterns of asthma, adjusted for potential confounding factors. Mediation analysis was performed to estimate the potential mediation effect of parents on the association between grandparental asthma and offspring asthma. Results: A paternal grandfather (OR: 2.59, 95%CI: 2.14-3.13), paternal grandmother (OR: 2.40, 95%CI: 1.93-2.99), maternal grandfather (OR: 2.08, 95%CI: 1.71-2.53) and maternal grandmother (OR: 2.08, 95%CI: 1.67-2.59) with asthma were associated with childhood asthma, independent of parental asthma. Of the children who had two family members with asthma, the risk of childhood asthma was highest when both parents had asthma (OR: 15.92, 95%CI: 4.66-54.45) or when both father and paternal grandfather had asthma (OR: 11.11, 95%CI: 5.77-21.38). Parents had a small proportion of mediation effect on the association between grandparental asthma and childhood asthma. Conclusions: A family history of grandparental asthma was associated with childhood asthma and parents only partially mediate the association.

Holistic Management of Pediatric Patients with Asthma through the Family Medicine Approach: A Case Series

“…12 The development of various asthma phenotypes is influenced by the role of various hereditary allergic diseases. 13,14 Parental allergic diseases are associated with late-onset asthma, where genetics plays a significant role. Asthma has a complex hereditary component involving several genes in its pathogenesis.…”

“…Apart from parents, grandparents with a history of asthma also increase the risk of the grandchildren developing asthma. 13,14 In Case 2, the patient had a cat, which is generally known to affect exacerbations in asthma because early life sensitization to animal fur is a potent predictor of asthma development in children. [15][16][17] In family medicine, many factors are considered, including personal, clinical, internal and external risk, and functional aspects.…”

“…-Asthma recurrence -Symptoms appeared after drinking cold drinks -Did not take asthma controller medication regularly -His aunt had a history of asthma -There was no ceiling on the roof -His mother was worried that asthma would interfere with school -Avoid the trigger 8 -Education to take asthma controller regularly 2 -Explain that hereditary history of asthma is a risk factor for asthma 13,14 -Improve house ventilation 24 -Educate his family regarding asthma 3,26 2.…”

“…-Asthma recurrence -Exposure to cigarettes, vehicle fumes, and cat dander -Grandmother, mother, and sister diagnosed with asthma since childhood -Worried about uncontrolled recurrence of symptoms that will have an impact on the future -Used independent costs because the family had not registered him with BPJS -Avoid the trigger 8,9,11,12,[15][16][17] -Explain that hereditary history of asthma is a risk factor for asthma 13,14 -Educate his family regarding asthma 3,26 -Advise family to register as BPJS participants [18][19][20][21] 3.…”

“…-Asthma recurrence -Exposure to dust, cold air, and smoke from burning corn plants around the warehouse -Mother had a history of allergies due to cold air -Her mother was worried that her asthma would get worse/could not be cured, causing complications and disrupting school as well as the future of the child, and impacting family activities and finances -The house got dirty quickly because it was located near a rice field -Avoid the trigger 8,9,11,12,15-17 -Explain that hereditary history of asthma is a risk factor for asthma 13,14 -Educate his family regarding asthma 3,26 and to take asthma controller regularly 2 -Advise family to register as BPJS participants [18][19][20][21] -Improve home conditions 24 4.…”