Robyn Wing1, Annie Gjelsvik2, Mariann Nocera3, Elizabeth L McQuaid4. 1. Departments of Emergency Medicine and Pediatrics, Section of Pediatric Emergency Medicine, Brown University/Hasbro Children's Hospital, Providence, Rhode Island; Warren Alpert Medical School of Brown University/Hasbro Children's Hospital, Providence, Rhode Island; School of Public Health, Brown University, Providence, Rhode Island. Electronic address: robyn_wing@brown.edu. 2. School of Public Health, Brown University, Providence, Rhode Island. 3. Departments of Emergency Medicine and Pediatrics, Section of Pediatric Emergency Medicine, Brown University/Hasbro Children's Hospital, Providence, Rhode Island; Warren Alpert Medical School of Brown University/Hasbro Children's Hospital, Providence, Rhode Island. 4. Warren Alpert Medical School of Brown University/Hasbro Children's Hospital, Providence, Rhode Island; Bradley/Hasbro Children's Research Center and Department of Psychiatry, Rhode Island Hospital, Providence, Rhode Island.
Abstract
BACKGROUND: Numerous studies suggest that psychosocial factors could contribute to pediatric asthma. OBJECTIVE: To examine the relation between single and cumulative adverse childhood experiences (ACEs), a measurement of household dysfunction, on parent report of lifetime asthma in children. METHODS: This cross-sectional study used data from the 2011 to 2012 National Survey of Children's Health, a nationally representative sample of children 0 to 17 years old (n = 92,472). The main exposure was parent or guardian report of 6 ACE exposures (eg, witnessing domestic violence). The relation between ACE exposures and parent-reported diagnosis of childhood asthma was examined using multivariable logistic regression after controlling for demographic, socioeconomic, and behavioral covariates. RESULTS: Overall asthma prevalence was 14.6%. Exposure prevalence to any ACE was 29.2%. Increased number of ACE exposures was associated with increased odds of asthma. In the adjusted model, the odds of reporting asthma were 1.28 (95% confidence interval [CI] 1.14-1.43) for those reporting 1 ACE, 1.73 (95% CI 1.27-2.36) for those with 4 ACEs, and 1.61 (95% CI 1.15-2.26) for those with 5 or 6 ACEs compared with those with no ACE exposures. Effects were moderated by Hispanic ethnicity. Hispanic children exposed to 4 ACEs had a 4.46 times increase in lifetime asthma (95% CI 2.46-8.08); white children had a 1.19 times increase (95% CI 0.80-1.79) compared with those exposed to 0 ACE. CONCLUSION: This study supports the growing evidence for the biopsychosocial model of asthma onset. Future studies should examine the association between ACEs and specific asthma-related health outcomes.
BACKGROUND: Numerous studies suggest that psychosocial factors could contribute to pediatric asthma. OBJECTIVE: To examine the relation between single and cumulative adverse childhood experiences (ACEs), a measurement of household dysfunction, on parent report of lifetime asthma in children. METHODS: This cross-sectional study used data from the 2011 to 2012 National Survey of Children's Health, a nationally representative sample of children 0 to 17 years old (n = 92,472). The main exposure was parent or guardian report of 6 ACE exposures (eg, witnessing domestic violence). The relation between ACE exposures and parent-reported diagnosis of childhood asthma was examined using multivariable logistic regression after controlling for demographic, socioeconomic, and behavioral covariates. RESULTS: Overall asthma prevalence was 14.6%. Exposure prevalence to any ACE was 29.2%. Increased number of ACE exposures was associated with increased odds of asthma. In the adjusted model, the odds of reporting asthma were 1.28 (95% confidence interval [CI] 1.14-1.43) for those reporting 1 ACE, 1.73 (95% CI 1.27-2.36) for those with 4 ACEs, and 1.61 (95% CI 1.15-2.26) for those with 5 or 6 ACEs compared with those with no ACE exposures. Effects were moderated by Hispanic ethnicity. Hispanic children exposed to 4 ACEs had a 4.46 times increase in lifetime asthma (95% CI 2.46-8.08); white children had a 1.19 times increase (95% CI 0.80-1.79) compared with those exposed to 0 ACE. CONCLUSION: This study supports the growing evidence for the biopsychosocial model of asthma onset. Future studies should examine the association between ACEs and specific asthma-related health outcomes.
Authors: Maria José Rosa; Allan C Just; Marcela Tamayo Y Ortiz; Lourdes Schnaas; Katherine Svensson; Robert O Wright; Martha María Téllez Rojo; Rosalind J Wright Journal: Ann Allergy Asthma Immunol Date: 2016-01-25 Impact factor: 6.347