Slone Epidemiology Center, Department of Medicine, Boston University School of Medicine, Boston University, Boston, MA 02215, USA.
J Allergy Clin Immunol. 2013 Apr;131(4):1058-63. doi: 10.1016/j.jaci.2012.10.023. Epub 2012 Dec 6.
Experiences of violence contribute to the occurrence of childhood asthma, but there is little information on the effect of early-life abuse on adult-onset asthma.
We prospectively assessed the relation between physical and sexual abuse during childhood and adolescence and the incidence of adult-onset asthma in the Black Women's Health Study.
We followed 28,456 women from 1995 through 2011 with biennial mailed questionnaires. Experiences of physical and sexual abuse that occurred during childhood and adolescence were obtained in 2005. Cox regression models were used to estimate incidence rate ratios (IRRs) and 95% CIs.
During 417,931 person-years of follow-up, 1,160 participants reported physician-diagnosed asthma and concurrent use of asthma medication. Compared with women who experienced no abuse during childhood or adolescence, the multivariable IRR for any childhood abuse was 1.24 (95% CI, 1.06-1.45), and for any adolescent abuse, it was 1.10 (95% CI, 0.88-1.36). The IRR was higher for childhood physical abuse (IRR, 1.29; 95% CI, 1.07-1.49) than for childhood sexual abuse (IRR, 1.15; 95% CI, 0.88-1.49). IRRs for physical and sexual abuse during adolescence were compatible with 1.0. The association between childhood abuse and asthma incidence was stronger in older compared with younger women.
In this large cohort of African American women, there was a positive association between adult-onset asthma and childhood physical abuse and weaker associations for childhood sexual abuse and any abuse during adolescence. Given the high prevalence of asthma and childhood abuse, this association is of public health importance.
暴力经历会导致儿童哮喘的发生，但关于儿童期虐待对成年后哮喘发病的影响知之甚少。
我们前瞻性评估了儿童和青少年时期身体和性虐待与黑人女性健康研究中成年后哮喘发病的关系。
我们从 1995 年开始随访 28456 名女性，每两年通过邮寄问卷进行一次随访。2005 年获得了儿童和青少年时期身体和性虐待的经历。使用 Cox 回归模型估计发病率比（IRR）和 95%置信区间（CI）。
在 417931 人年的随访期间，有 1160 名参与者报告了医生诊断的哮喘和同时使用哮喘药物。与儿童或青少年时期未遭受虐待的女性相比，任何儿童期虐待的多变量 IRR 为 1.24（95%CI，1.06-1.45），任何青少年期虐待的 IRR 为 1.10（95%CI，0.88-1.36）。儿童期身体虐待的 IRR （IRR，1.29；95%CI，1.07-1.49）高于儿童期性虐待的 IRR（IRR，1.15；95%CI，0.88-1.49）。青春期身体和性虐待的 IRR 与 1.0 相符。与年轻女性相比，老年女性的虐待与哮喘发病之间的关联更强。
在这个大型非裔美国女性队列中，成人后哮喘与儿童期身体虐待之间存在正相关，而儿童期性虐待和青春期任何虐待的相关性较弱。鉴于哮喘和儿童虐待的高患病率，这种相关性具有重要的公共卫生意义。
