Prediction of early-onset asthma in genetically at-risk children

Abstract

The W.T. Grant Foundation Asthma Risk Study was designed to prospectively examine children who were considered at a genetically increased risk for the development of asthma. The respective contributions of 11 potential risk factors, both environmental and biological, were assessed in order to determine their relative roles in affecting the early onset of asthma. This is a report of an inception cohort of children born to asthmatic mothers and followed for a 3‐year period. All 150 families were recruited from the general community and living within 2 h of the National Jewish Center for Immunology and Respiratory Medicine (Denver, CO). Mothers in the index risk sample had been previously diagnosed with asthma and were recruited during their pregnancy through physician referrals and media solicitation. The index sample of 150 families was 92% Caucasian and predominantly middle class. The mean age of mothers was 29.3 years, and of fathers, 31.1 years. The main outcome was the determination of the early onset of asthma and its association with quantified risk factors. By age 3 years, 14 of the 150 children had developed asthma. Frequent illness, IgE levels at age 6 months, parenting difficulties, and early eczema were significantly associated with the onset of asthma (P = 0.003, P = 0.006, P = 0.0l, and P = 0.03, respectively). Only frequent illness, elevated serum IgE levels, and parenting difficulties entered a predictive model where they were independently related to the development of asthma. Pediatr Pulmonol. 1999; 27:85–94. © 1999 Wiley‐Liss, Inc.

Onset and Persistence of Childhood Asthma: Predictors From Infancy

“…Among variables reported previously to predict asthma onset by age 3 21 among these genetically at-risk children, 3 proved to have significant univariate relationships with asthma between ages 6 and 8: elevated IgE levels measured when the children were 6 months of age, global ratings of parenting difficulties measured when infants were 3 weeks old, and higher numbers of respiratory infections in the first year of life (Table 1). Although paternal asthma was not an additional predictor for asthma onset at age 3 among these offspring of mothers with asthma, it showed a significant association with asthma between ages 6 and 8.…”

“…At 6 months, a level of Ն10 IU/mL has been demonstrated to be associated with early-onset asthma. 1,21 IgE data were log-transformed for statistical analyses then back-transformed and reported as geometric means to allow for meaningful comparisons.…”

“…Although paternal asthma was not an additional predictor for asthma onset at age 3 among these offspring of mothers with asthma, it showed a significant association with asthma between ages 6 and 8. Eczema in the first year, reported previously to bear a significant univariate relationship with early-onset asthma, 21 was not significantly related to later asthma.…”

“…The status of these children at age 3 is reported elsewhere. 21 Three variables from the first year of life independently predicted asthma onset by 3 years of age. These were elevated serum IgE (Ն10 IU/mL) obtained when the children were 6 months old, 8 or more respiratory infections during the first year of life, and parenting difficulties when the infants were 3 weeks of age.…”

Stress and the City: Housing Stressors are Associated with Respiratory Health among Low Socioeconomic Status Chicago Children

“…13 Studies link stress to asthma onset, exacerbation and phenotypes through hypothesized "dysregulated immunity" mechanisms. 10,12,[14][15][16][17][18][19][20][21][22] Stress experienced by children or their parents may also have indirect effects on asthma by causing health-compromising behaviors and comorbidities that adversely affect disease management. [23][24][25][26][27][28][29][30][31][32][33][34] Caregiver stress, negative life events, problematic family relationships, parenting difficulties, critical attitudes of one's mother and violence exposure have been related to wheeze, asthma onset, and/or adverse asthma outcomes among infants and youths.…”