Understanding social inequalities in childhood asthma: Quantifying the mediating role of modifiable early-life risk factors in seven european birth cohorts
Mostra el registre complet Registre parcial de l'ítem
- dc.contributor.author Pinot de Moira, Angela
- dc.contributor.author García Aymerich, Judith
- dc.contributor.author Vrijheid, Martine
- dc.contributor.author Nybo Andersen, Anne-Marie
- dc.date.accessioned 2025-06-13T07:45:55Z
- dc.date.available 2025-06-13T07:45:55Z
- dc.date.issued 2025
- dc.description.abstract Background: Children growing up in disadvantaged socioeconomic circumstances (SECs) have an increased risk of asthma. Objective: To increase our understanding of the pathways to inequalities in asthma and potential targets for intervention by (1) examining how the social patterning of asthma and its early-life risk factors varies across countries and (2) quantifying the mediation of observed inequalities by early-life risk factors. Methods: We used data for 107,884 mother-child dyads from 7 European birth cohorts across 6 countries. Maternal education was the primary exposure measure of early-life SECs. The outcome was current asthma in childhood (3-12 years). Inequalities were examined using multivariable regression and random effects meta-analysis. The mediating effects of early-life risk factors (maternal smoking during pregnancy, adverse birth outcomes, and breastfeeding duration) were examined using counterfactual mediation analysis. Results: In meta-analysis, children of mothers with low/medium versus high education had a 17% (95% confidence interval: 8%-27%, I2 = 21.6%) increased risk of asthma. Cohort-specific risk ratios ranged between 1.07 (0.97-1.18, Danish National Birth Cohort, Denmark) and 1.61 (1.08-2.40, study on the pre- & early postnatal determinants of child health & development, France). The early-life risk factors were similarly socially patterned, but with greater heterogeneity across cohorts (I2 range = 66.2%-95.3%). The mediation analysis suggested that these factors play a relevant role in mediating observed inequalities (proportion mediated range: 0.08-0.72). Conclusions: There was a consistent tendency for children from disadvantaged SECs to be at greater risk of asthma in the European cohorts examined. Our results suggest that early-life risk factors partially mediate these disparities and, therefore, that public health interventions in the perinatal period may help to address inequalities in asthma.
- dc.format.mimetype application/pdf
- dc.identifier.citation Pinot de Moira A, Aurup AV, Avraam D, Zugna D, Jensen AKG, Welten M, et al. Understanding social inequalities in childhood asthma: Quantifying the mediating role of modifiable early-life risk factors in seven european birth cohorts. J Allergy Clin Immunol Pract. 2025 Jun;13(6):1385-96. DOI: 10.1016/j.jaip.2025.02.032
- dc.identifier.doi http://dx.doi.org/10.1016/j.jaip.2025.02.032
- dc.identifier.issn 2213-2198
- dc.identifier.uri http://hdl.handle.net/10230/70677
- dc.language.iso eng
- dc.publisher Elsevier
- dc.relation.ispartof J Allergy Clin Immunol Pract. 2025 Jun;13(6):1385-96
- dc.rights © 2025 The Authors. Published by Elsevier Inc. on behalf of the American Academy of Allergy, Asthma & Immunology. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
- dc.rights.accessRights info:eu-repo/semantics/openAccess
- dc.rights.uri http://creativecommons.org/licenses/by/4.0/
- dc.subject.keyword Birth cohort
- dc.subject.keyword Childhood asthma
- dc.subject.keyword Cross-cohort
- dc.subject.keyword Inequalities
- dc.subject.keyword Meta-analysis
- dc.subject.keyword Socioeconomic
- dc.title Understanding social inequalities in childhood asthma: Quantifying the mediating role of modifiable early-life risk factors in seven european birth cohorts
- dc.type info:eu-repo/semantics/article
- dc.type.version info:eu-repo/semantics/publishedVersion