Factors associated with asthma and wheezing in children: The role of personal, household, home, environmental, and behavioral characteristics.

OBJECTIVES

We assessed factors associated with asthma and wheezing in children using a comprehensive approach encompassing child, perinatal, household, home, and behavioral characteristics.

STUDY

DESIGN

A cross-sectional study was performed, inviting parents/legal guardians of 2629 children (5-11 years) from 20 public primary schools in Porto, Portugal.

METHODS

Data were collected using structured questionnaires completed by parents/legal guardians. Multivariable logistic regression models assessed the adjusted associations between potential factors and ever-asthma, current asthma, and wheezing.

RESULTS

Overall, 1145 children completed the questionnaire (response rate: 43.5%). Early-life respiratory illnesses were consistently associated with respiratory outcomes. Pneumonia (OR = 4.69; 95%CI = 2.45-8.99), bronchitis (OR = 1.98; 95% CI = 1.19-3.29), and bronchiolitis (OR = 2.66; 95% CI = 1.73-4.11) were associated with higher odds of ever-asthma, while bronchitis (OR = 3.30; 95%CI = 2.21-4.94) and bronchiolitis (OR = 5.72; 95%CI = 4.28-7.64) were also associated with higher odds of wheezing. Family history of asthma was associated with ever-asthma (OR = 2.20; 95%CI = 1.39-3.49), whereas having siblings was associated with higher odds of wheezing (OR = 1.40; 95%CI = 1.02-1.94). Home renovation or remodeling was associated with lower odds of ever-asthma (OR = 0.43; 95%CI = 0.26-0.69) and wheezing (OR = 0.56; 95%CI = 0.41-0.76), while home mold growth was associated with higher odds of wheezing (OR = 2.37; 95%CI = 1.72-3.26). Living in detached houses was associated with lower odds of current asthma (OR = 0.42; 95%CI = 0.22-0.89), whereas living in flat houses (OR = 1.72; 95%CI = 1.00-2.96) and using a dry cloth for cleaning (OR = 1.36; 95%CI = 1.01-1.83) were associated with higher odds of wheezing.

CONCLUSIONS

Despite the inherent limitations in establishing causality, the findings highlight the multifactorial nature of childhood asthma and wheezing and their associations with early-life, household, home, and behavioral factors.