Janus Magdalena, Reid-Westoby Caroline, Pottruff Molly, Schneeweiss Michelle, Hu George, Brownell Marni
Offord Centre for Child Studies, Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario L8S 4K1, Canada.
Human Early Learning Partnership, School of Population and Public Health, University of British Columbia, Vancouver, British Columbia V6T 1Z3, Canada.
Prev Med Rep. 2023 Nov 22;37:102525. doi: 10.1016/j.pmedr.2023.102525. eCollection 2024 Jan.
Asthma can impact children's quality of life. It is unclear how asthma is associated with the developmental health (i.e. a broad range of skills and abilities associated with growth and development) of young children at school entry. The goals of this cross-sectional, population-level study were to: (1) investigate the association between teacher-reported asthma and children's concurrent indicators of developmental health (developmental vulnerability); and (2) explore whether school absences and functional impairments modified this association. Participants were a Canadian population-based sample of 564 582 kindergarten children = 5.71 years, = 0.32, 51.3 % male) with data on the (EDI) collected between 2010 and 2015. Adjusted binary logistic regressions were conducted to address the objectives. From the sample, 958 (0.2 %) children were identified as having a diagnosis of asthma. These children were absent on average 9.4 days and 53.5 % had functional impairments (vs. 6.7 days absent and 15.9 % with functional impairments in children without asthma). After controlling for demographic characteristics, children with asthma had between 1.51 and 2.42 higher odds of being developmentally vulnerable. Only the presence of functional impairments modified this relationship and only for physical health and well-being. In this large, population-based sample of Canadian kindergarten children, few teachers reported knowledge of their students' asthma diagnosis. Among teacher-reported cases, asthma was a risk factor for developmental vulnerability in the domain of physical health and well-being only. Functional impairments may therefore be more detrimental for child development at school entry than asthma alone.
哮喘会影响儿童的生活质量。目前尚不清楚哮喘与幼儿入学时的发育健康(即与生长发育相关的广泛技能和能力)之间是如何关联的。这项横断面、基于人群的研究的目的是:(1)调查教师报告的哮喘与儿童发育健康的并发指标(发育脆弱性)之间的关联;(2)探讨缺课和功能障碍是否会改变这种关联。研究对象是加拿大一个基于人群的样本,包括564582名幼儿园儿童(平均年龄=5.71岁,标准差=0.32,51.3%为男性),收集了2010年至2015年期间的早期发展指标(EDI)数据。进行了调整后的二元逻辑回归以实现研究目标。在样本中,958名(0.2%)儿童被确诊患有哮喘。这些儿童平均缺课9.4天,53.5%有功能障碍(相比之下,无哮喘儿童的平均缺课天数为6.7天,有功能障碍的比例为15.9%)。在控制了人口统计学特征后,患有哮喘的儿童发育脆弱的几率高出1.51至2.42倍。只有功能障碍会改变这种关系,且仅针对身体健康和幸福方面。在这个基于加拿大幼儿园儿童的大型人群样本中,很少有教师报告了解其学生的哮喘诊断情况。在教师报告的病例中,哮喘仅是身体健康和幸福领域发育脆弱的一个危险因素。因此,功能障碍对儿童入学时的发育可能比哮喘本身更具危害性。