Centre for Big Data Research in Health, University of New South Wales, Sydney, New South Wales, Australia
School of Women's and Children's Health, University of New South Wales, Sydney, 2033, New South Wales, Australia.
Thorax. 2021 Jun;76(6):539-546. doi: 10.1136/thoraxjnl-2020-216189. Epub 2021 Jan 8.
Australia has one of the highest rates of asthma worldwide. Indigenous children have a particularly high burden of risk determinants for asthma, yet little is known about the asthma risk profile in this population.
To identify and quantify potentially preventable risk factors for hospitalised asthma in Australian Aboriginal children (1-4 years of age).
Birth, hospital and emergency data for all Aboriginal children born 2003-2012 in Western Australia were linked (n=32 333). Asthma was identified from hospitalisation codes. ORs and population attributable fractions were calculated for maternal age at birth, remoteness, area-level disadvantage, prematurity, low birth weight, maternal smoking in pregnancy, mode of delivery, maternal trauma and hospitalisations for acute respiratory tract infection (ARTI) in the first year of life.
There were 705 (2.7%) children hospitalised at least once for asthma. Risk factors associated with asthma included: being hospitalised for an ARTI (OR 4.06, 95% CI 3.44 to 4.78), area-level disadvantage (OR 1.58, 95% CI 1.28 to 1.94), being born at <33 weeks' gestation (OR 3.30, 95% CI 2.52 to 4.32) or birth weight <1500 g (OR 2.35, 95% CI 1.39 to 3.99). The proportion of asthma attributable to an ARTI was 31%, area-level disadvantage 18%, maternal smoking 5%, and low gestational age and birth weight were 3%-7%. We did not observe a higher risk of asthma in those children who were from remote areas.
Improving care for pregnant Aboriginal women as well as for Aboriginal infants with ARTI may help reduce the burden of asthma in the Indigenous population.
澳大利亚的哮喘发病率居全球前列。土著儿童患哮喘的风险因素尤其多，但人们对这一人群的哮喘风险特征知之甚少。
确定并量化澳大利亚土著儿童（1-4 岁）住院哮喘的潜在可预防风险因素。
对西澳大利亚州 2003-2012 年所有土著儿童的出生、住院和急诊数据进行了链接（n=32333）。通过住院代码确定哮喘。计算了母亲出生时的年龄、偏远程度、地区层面的贫困程度、早产、低出生体重、孕妇怀孕期间吸烟、分娩方式、母亲创伤和婴儿期急性呼吸道感染（ARTI）住院治疗的比值比（OR）和人群归因分数（PAF）。
共有 705 名（2.7%）儿童因哮喘至少住院一次。与哮喘相关的风险因素包括：因 ARTI 住院（OR 4.06，95%CI 3.44-4.78）、地区层面的贫困程度（OR 1.58，95%CI 1.28-1.94）、出生时胎龄<33 周（OR 3.30，95%CI 2.52-4.32）或出生体重<1500g（OR 2.35，95%CI 1.39-3.99）。哮喘归因于 ARTI 的比例为 31%，地区层面的贫困程度为 18%，母亲吸烟为 5%，低胎龄和低出生体重为 3%-7%。我们没有观察到来自偏远地区的儿童哮喘风险更高。
改善土著孕妇和患有 ARTI 的土著婴儿的护理可能有助于减轻土著人群的哮喘负担。
