Socioeconomically disadvantaged communities in the United States have disproportionately high number of children diagnosed with asthma. We investigated the various risk factors that might contribute to the disease in a cohort of children born to high-risk families.

  Methods

            The Fragile Families and Child Wellbeing Study is a longitudinal cohort of approximately 5000 children from mostly unwed parents across the United States. Data from interviews with mothers conducted shortly after birth and follow-up surveys at one year were used for this analysis. Infant asthma was identified when the child was treated by health care professionals for asthma or when the child had more than one episode of asthma attack. Multivariate regression analysis was used to identify independent risk factors for asthma in this population.

  Results

            13.5% of the respondents (n=506 of 3747) had an infant with asthma. Significant risk factors associated with infant asthma included maternal cigarette smoking, low child weight, child's male gender, and African-American race. Breastfeeding had a protective effect. (Table 1)    Table 1

Risk Factor	Odds Ratio	95% CI	p-value
Breastfeeding	0.79	0.64-0.97	0.024
Maternal Cigarette Smoking	1.40	1.12-1.74	0.003
Child's Weight	1.22	1.02-1.46	0.032
Male Gender	0.56	0.46-0.69	0.000
African-American Race	2.52	1.94-3.28	0.000

Conclusion

            Environmental factors interact with a child's characteristics in contributing to infantile asthma. Policies that promote breastfeeding, discourage maternal cigarette smoking, and identify high-risk children could reduce asthma incidence.