Personal and early life factors associated with new-onset asthma, remission, and persistence of asthma in a 2-year follow-up of schoolchildren

Abstract

Objective

The natural course of childhood asthma, after its onset, is characterized by periods of persistence, relapse and remission. To investigate personal and early life factors associated with new-onset asthma, persistence and remission among children.

Methods

The study was conducted in the province of Saskatchewan, Canada. Children in grades Kindergarten to Grade 8 (ages 5–14 years) participated in a cross-sectional study in 2013. In 2015, we approached those who gave consent in 2013 to be re-contacted, creating a prospective cohort. Data were collected using questionnaires in both years. Participants in 2013 who also had data in 2015 (25%: n = 324/1,348) had their asthma status reclassified and longitudinal descriptors were applied: “no asthma”, “new-onset asthma”, “persistent” or “remission”. Personal and early life factors associations with asthma outcomes in 2015 were evaluated.

Results

Among those without asthma in 2013 (n = 245), the incidence of new-onset asthma in 2015 was 7.2%. Among those with asthma in 2013 (n = 79), 47.1% had remission and 52.9% had persistent asthma in 2015. Parental history of asthma (adjusted odds ratio (aOR): 4.99; 95% confidence interval (CI): 1.88–28.27), early life respiratory infection (aOR: 1.92; 95%CI: 1.47–7.88), early life allergy [aOR: 6.39; 95%CI: 1.34–30.58) and early life infection (aOR: 4.99; 95%CI: 1.19–20.93) were associated with new onset asthma. Similarly, while parental history of asthma (aOR: 1.13; 95%CI: 0.29–4.34), early life respiratory infection (aOR: 2.71; 95%CI: 0.70–10.45), and early life ear infection (aOR: 1.34; 95%CI: 0.36–5.05) were also positively association with persistent asthma, the associations were not statistically significant.

Conclusion

Parental history of asthma, early life respiratory infection and allergy might not only influence the onset of childhood asthma but also be associated with asthma persistence.

Keywords:

• New-onset asthma
• remission
• persistence
• predictors
• children
• Canada

Acknowledgements

The authors would like to thank all the participants, their parents, school boards to make this study possible. Dr. Oluwole is supported by the Saskatchewan Health Research Foundation (SHRF) Research Fellowship and the Canadian Center for Health and Safety in Agriculture Founding Chair. The authors are also grateful to all research assistants (L. Chu, U. Singh, and X. Zeng, and O. Awoyera) and field nurses (C. Mackinnon, and E. Baron) for successful execution of data collection.

Disclosure statement

The authors have no conflict of interest related to this study to disclose.

Additional information

Funding

This research was funded by a Saskatchewan Health Research Foundation (SHRF) New Investigator Establishment Grant and the College of Medicine, University of Saskatchewan. Dr. Lawson is supported through fall-in funds from the Canadian Institutes of Health Research (CIHR) and Lung Association of Saskatchewan (LAS) partnered New Investigator Salary Support Award in Pediatric Asthma.