Duration of day care attendance during infancy predicts asthma at the age of seven: the Cincinnati Childhood Allergy and Air Pollution Study. Issue 10 (October 2014)

• Record Type: Journal Article
• Authors: Cheng, G.; Smith, A. M.; Levin, L.; Epstein, T.; Ryan, P. H.; LeMasters, G. K.; Khurana Hershey, G. K.; Reponen, T.; Villareal, M.; Lockey, J.; Bernstein, D. I.
• Is Part Of: Clinical & experimental allergy. Volume 44:Issue 10(2014:Oct.)
• Page Start: 1274
• Page End: 1281
• Publication Date: 2014-10
• Subjects: Allergy -- Periodicals; Immunology -- Periodicals; 616.97
• DOI: 10.1111/cea.12397
• Languages: English
• ISSNs: 0954-7894

Abstract

<abstract abstract-type="main" id="cea12397-abs-0001"> <title>Summary</title> <sec id="cea12397-sec-0001" sec-type="section"> <title>Background</title> <p>Studies vary with respect to the reported effects of day care attendance on childhood asthma.</p> </sec> <sec id="cea12397-sec-0002" sec-type="section"> <title>Objectives</title> <p>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.</p> </sec> <sec id="cea12397-sec-0003" sec-type="section"> <title>Method</title> <p>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.</p> </sec> <sec id="cea12397-sec-0004" sec-type="section"> <title>Results</title> <p>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)].</p> </sec> <sec id="cea12397-sec-0005" sec-type="section"> <title>Conclusion</title> <p>Depending on duration of attendance, day care during infancy can either increase or reduce risk of asthma at the age of seven.</p> </sec> </abstract>