Duration of day care attendance during infancy predicts asthma at the age of seven: the Cincinnati Childhood Allergy and Air Pollution Study.

Abstract

BACKGROUND:

Studies vary with respect to the reported effects of day care attendance on childhood asthma.

OBJECTIVES:

To evaluate the independent and combined effects of day care attendance and respiratory infections on the development of asthma at the age of seven in a prospective birth cohort.

METHOD:

At the age of seven, the study sample included 589 children with complete data of 762 enrolled at birth. Day care hours and number of respiratory infections were reported in follow-up questionnaires through age four. At 7 years of age, asthma was diagnosed in 95 children (16%), based on predefined symptoms criteria confirmed by either asthma FEV1 reversibility after bronchodilator or a positive methacholine test (PC20 ≤ 4 mg/mL). Logistic regression was used to investigate the relationships between asthma at the age of seven, cumulative hours of day care attendance and reported respiratory infections at ages 1-4.

RESULTS:

In the univariate analyses, day care attendance at 12 months was associated with an increased risk of asthma [odds ratio (OR) = 1.8, 95% confidence interval (CI) = 1.1-3.0]. Both upper and lower respiratory infections at 12 months also increased the likelihood of asthma [OR = 2.4 (1.4-4.1); OR = 2.3 (1.5-3.7), respectively]. In the final multivariate logistic model, cumulative hours of day care attendance and number of lower respiratory infections at 12 months were associated with asthma [OR = 1.2 (1.1-1.5); OR = 1.4 (1.2-1.7), respectively]. However, a threshold of greater than 37.5 hours per week of day care attendance was associated with a lower risk of asthma [OR = 0.6 (0.4-0.9)].

CONCLUSION:

Depending on duration of attendance, day care during infancy can either increase or reduce risk of asthma at the age of seven.

• Authors: G Cheng, A M Smith, L Levin, T Epstein, P H Ryan, G K LeMasters, G K Khurana Hershey, T Reponen, M Villareal, J Lockey, D I Bernstein
• Journal: Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology (Clin Exp Allergy) Vol. 44 Issue 10 Pg. 1274-81 (Oct 2014) ISSN: 1365-2222 [Electronic] England
• PMID: 25179746 (Publication Type: Journal Article)
• Copyright: © 2014 John Wiley & Sons Ltd.

Topics

• Air Pollution (adverse effects)
• Asthma (etiology)
• Child
• Child Day Care Centers
• Female
• Humans
• Infant
• Logistic Models
• Male
• Respiratory Tract Infections (complications)
• Surveys and Questionnaires
• Time Factors