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a Centre for
Community Child Health, Royal Children's Hospital Melbourne,
Parkville, Victoria 3052, Australia, b Department of Paediatrics and Child Health,
University of Sydney, NSW 2006, Australia, c Institute of Respiratory Medicine, University of
Sydney, d Faculty
of Medicine, University of Sydney
Correspondence to: Dr M M Haby michelle.haby{at}dhs.vic.gov.au
Received 16 August 2000; Returned to authors 4 December 2000; Revised version received 19 March 2001; Accepted for publication 23 April 2001
BACKGROUND
The
prevalence of asthma in children has increased in many countries over
recent years. To plan effective interventions to reverse this trend we
need a better understanding of the risk factors for asthma in early
life. This study was undertaken to measure the prevalence of, and risk
factors for, asthma in preschool children.
METHODSParents of
children aged 3-5 years living in two cities (Lismore, n=383; Wagga
Wagga, n=591) in New South Wales, Australia were surveyed by
questionnaire to ascertain the presence of asthma and various proposed
risk factors for asthma in their children. Recent asthma was defined as
ever having been diagnosed with asthma and
having cough or wheeze in the last 12 months
and having used an asthma medication in the
last 12 months. Atopy was measured by skin prick tests to six common allergens.
RESULTSThe prevalence
of recent asthma was 22% in Lismore and 18% in Wagga Wagga. Factors
which increased the risk of recent asthma were: atopy (odds ratio (OR)
2.35, 95% CI 1.49 to 3.72), having a parent with a history of asthma
(OR 2.05, 95% CI 1.34 to 3.16), having had a serious respiratory
infection in the first 2 years of life (OR 1.93, 95% CI 1.25 to 2.99),
and a high dietary intake of polyunsaturated fats (OR 2.03, 95% CI
1.15 to 3.60). Breast feeding (OR 0.41, 95% CI 0.22 to 0.74) and
having three or more older siblings (OR 0.16, 95% CI 0.04 to 0.71)
decreased the risk of recent asthma.
CONCLUSIONSOf the
factors tested, those that have the greatest potential to be modified
to reduce the risk of asthma are breast feeding and consumption of
polyunsaturated fats.
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