Abstract

Objective

To examine the association between daycare attendance and asthma control among children aged 0 to 4 years with asthma

Methods

We analyzed 2012–2014 data from the Behavioral Risk Factor Surveillance System Asthma Call-back Survey on 388 children with asthma aged 0 to 4 years with information on daycare attendance in the past 12 months. We calculated weighted prevalence ratios to assess the association between daycare attendance and asthma control (categorized based on day-time and nighttime asthma symptoms, activity limitation, and short-acting beta agonist use). Adjusted models controlled for parent or guardian education, household income, race, sex, cost barriers to asthma care, long-term control medication use, and the number of other children in the child’s household.

Results

In this sample of children with asthma, representative of 520,400 children in 26 U.S. states, 34% attended daycare in the past 12 months. Only 32% of children who attended daycare in the past 12 months reported having an asthma action plan on file at the daycare they most recently attended. Presence of the asthma triggers of pets, mold, and smoking in a child’s daycare were reported to be uncommon. Prevalence of uncontrolled asthma was 44% in children who attended daycare in the past 12 months and 68% in children who did not. The adjusted prevalence ratio between daycare attendance and uncontrolled asthma was 0.96 (95% confidence interval 0.73, 1.25).

Conclusions

When adjusting for covariates, we observed no evidence of an association between daycare attendance in early life and uncontrolled asthma.

中文翻译：

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日托出勤率和哮喘控制，哮喘回访调查 2012-2014

摘要

客观的

研究 0 至 4 岁哮喘儿童的日托出勤率与哮喘控制之间的关系

方法

我们分析了 2012 年至 2014 年行为风险因素监测系统哮喘回访调查的数据，该调查对 388 名 0 至 4 岁哮喘儿童进行了调查，并提供了过去 12 个月的日托出勤信息。我们计算了加权患病率以评估日托出勤率与哮喘控制之间的关联（根据白天和夜间的哮喘症状、活动受限和短效 β 受体激动剂的使用进行分类）。针对父母或监护人教育、家庭收入、种族、性别、哮喘护理的成本障碍、长期控制药物使用以及儿童家庭中其他儿童的数量控制的调整模型。

结果

在这个哮喘儿童样本中，代表美国 26 个州的 520,400 名儿童，其中 34% 在过去 12 个月内参加了日托。在过去 12 个月内参加日托的儿童中，只有 32% 的儿童报告说他们最近参加的日托有一份哮喘行动计划。据报道，儿童日托中宠物、霉菌和吸烟引起的哮喘诱因并不常见。在过去 12 个月内上过日托的儿童中，未控制的哮喘患病率为 44%，在未上过日托的儿童中为 68%。日托出勤率和未控制的哮喘之间的调整患病率比为 0.96（95% 置信区间 0.73, 1.25）。

结论

在调整协变量时，我们没有观察到证据表明生命早期的日托出勤率与不受控制的哮喘之间存在关联。