Adverse childhood experiences and asthma: trajectories in a national cohort

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  • Kathrine Pape, National Research Centre for the Working Environment
  • ,
  • Whitney Cowell, Icahn School of Medicine at Mount Sinai
  • ,
  • Camilla Sandal Sejbaek, National Research Centre for the Working Environment
  • ,
  • Niklas Worm Andersson, Statens Serum Institut, København Universitet
  • ,
  • Cecilie Svanes, Department of Biology, University of Bergen, Bergen, Norway; Sars International Centre, Uni Research, University of Bergen, Bergen, Norway.
  • ,
  • Henrik Albert Kolstad
  • Xiaoqin Liu
  • Karin Sørig Hougaard, National Research Centre for the Working Environment, University of Copenhagen
  • ,
  • Rosalind J Wright, Icahn School of Medicine at Mount Sinai
  • ,
  • Vivi Schlünssen

OBJECTIVE: Research has linked early adverse childhood experiences (ACEs) with asthma development; however, existing studies have generally relied on parent report of exposure and outcome. We aimed to examine the association of early life ACEs with empirically determined trajectories of childhood asthma risk, using independent register information on both exposures and outcome.

METHODS: Based on nationwide registries, we established a study cohort of 466 556 children born in Denmark (1997-2004). We obtained information on ACEs during the first 2 years of life (bereavement, parental chronic somatic and/or mental illness) and childhood asthma diagnosis or medication use from birth through age 10 years from the Danish National Patient and Prescription Registries, respectively. We identified asthma phenotypes using group-based trajectory modelling. We then used multinomial logistic regression to examine the association between early ACEs and asthma phenotypes.

RESULTS: We identified four asthma phenotypes: non-asthmatic, early-onset transient, early-onset persistent and late-onset asthma. Girls with early-onset transient asthma (OR 1.13, 95% CI 1.04 to 1.24), early-onset persistent asthma (1.27, 95% CI 1.08 to 1.48) or late-onset asthma (OR 1.28, 95% CI 1.11 to 1.48) vs no asthma were more likely to have early life ACE exposure compared with girls without ACE exposure. Results were similar for boys who also had experienced early life ACEs with ORs of 1.16 (95% CI 1.08 to 1.25), 1.34 (95% CI 1.20 to 1.51) and 1.11 (95% CI 0.98 to 1.25), respectively.

CONCLUSION: In a nationwide-population study, we identified three childhood onset asthma phenotypes and found that ACEs early in life were associated with increased odds for each of these asthma phenotypes among both girls and boys.

Original languageEnglish
JournalThorax
Volume76
Issue6
Pages (from-to)547-553
Number of pages7
ISSN0040-6376
DOIs
Publication statusPublished - Jun 2021

Bibliographical note

© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

    Research areas

  • asthma, asthma epidemiology, paediatric asthma

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