Maternal age and asthma in Latino populations.

BACKGROUND: Younger maternal age at birth is associated with increased risk of asthma in offspring in European descent populations, but has not been studied in Latino populations. OBJECTIVES: We sought to examine the relationship between maternal age at birth and prevalence of asthma in a nationwide study of Latino children. METHODS: We included 3473 Latino children aged 8-21 years (1696 subjects with physician-diagnosed asthma and 1777 healthy controls) from five US centres and Puerto Rico recruited from July 2008 through November 2011. We used multiple logistic regression models to examine the effect of maternal age at birth on asthma in offspring overall and in analyses stratified by ethnic subgroup (Mexican American, Puerto Rican and other Latino). Secondary analyses evaluated the effects of siblings, acculturation and income on this relationship. RESULTS: Maternal age < 20 years was significantly associated with decreased odds of asthma in offspring, independent of other risk factors (OR = 0.73, 95% CI: 0.57-0.93). In subgroup analyses, the protective effect of younger maternal age was observed only in Mexican Americans (OR = 0.53, 95% CI: 0.36, 0.79). In Puerto Ricans, older maternal age was associated with decreased odds of asthma (OR = 0.65, 95% CI: 0.44-0.97). In further stratified models, the protective effect of younger maternal age in Mexican Americans was seen only in children without older siblings (OR = 0.44, 95% CI: 0.23-0.81). CONCLUSION AND CLINICAL RELEVANCE: In contrast to European descent populations, younger maternal age was associated with decreased odds of asthma in offspring in Mexican American women. Asthma is common in urban minority populations but the factors underlying the varying prevalence among different Latino ethnicities in the United States is not well understood. Maternal age represents one factor that may help to explain this variability.

Risk of readmission to hospital for pediatric asthma.

To describe risk for hospital readmission for pediatric asthma occurring within 12 months of index hospital admission, we reviewed the medical records of all pediatric (age < 15 years) patients admitted for asthma to the Kaiser Foundation Hospital (KFH), Hayward, California, between September 30, 1991 and June 30, 1993. Patients aged < 5 years or who had a history of prior hospital admission were at high risk for hospital readmission within 12 months of the index admission. A single-session asthma class did not reduce risk for hospital readmission.

Young inner-city children visiting the emergency room (ER) for asthma: risk factors and chronic care behaviors.

Inner-city children visiting emergency rooms (ER) for asthma often rely on the ER as their primary source of care. To evaluate chronic asthma control, structured interviews were conducted with the adult accompanying a sample of 46 children, 2-6 years old, presenting to an inner-city pediatric ER for asthma. Fifty-one percent had 10 or more prior ER visits and 46% had 2 or more previous hospitalizations. Seventy-two percent had functional severity scores in the moderate to severe range. Only 11% used daily inhaled anti-inflammatory medication. Not one patient had a written self-management plan. Most young children visiting an inner-city ER for asthma have poorly controlled and poorly managed chronic asthma.

Primary family contacts and emotional health in the institutionalized elderly.

Research among nondemented elderly living independently in the community suggests that increased social support is associated with improved emotional and physical health. Relatively little research has examined associations between social supports and health among the institutionalized elderly. A sample of 70 nondemented, elderly nursing-home patients was studied to determine associations between qualitative and quantitative aspects of patients' relationships with their primary family contact and measures of emotional well-being, including depression, hopelessness, and life satisfaction. Significant correlations between quality of relationships and all domains of emotional well-being were found. None of the correlations between frequency of interaction and measures of emotional health were significant. A hierarchical regression analysis demonstrated that the correlation between quality of relationships and depression and life satisfaction was independent of functional status, mental status, age, type of relation, and frequency of visits. These results are consistent with studies of the noninstitutionalized elderly.

Trends in asthma prevalence: the Bogalusa Heart Study.

BACKGROUND: Epidemiologic surveys from different parts of the developed world are showing increases in asthma prevalence; the causes are not known. OBJECTIVE: To describe trends in prevalence of childhood asthma measured across serial cross-sectional surveys of the school age population of Bogalusa, Louisiana. METHODS: The Bogalusa Heart Study is a long-term epidemiologic study of risk factors for cardiovascular disease in children in a stable, semirural, biracial community. Part of the examination includes a parent-completed health history questionnaire. The item, "Does your child have or has your child had in the past...asthma?" was included in the 1983-5, 1987-8, and 1992-4 surveys. Data analysis was restricted to subjects aged 5 to 17 years. RESULTS: Three thousand two hundred seventy-six subjects participated in 1983-5, 3256 in 1987-8, and 3128 in 1992-4. Reported asthma prevalence increased from 9.2% to 15.9% between 1983-5 and 1992-4. Maternal smoking was associated with asthma in all three surveys. Young age and African American ethnicity were associated with asthma only in the 1992-4 survey. CONCLUSIONS: The prevalence of asthma among the school age population of Bogalusa, Louisiana increased by 73% between the 1983-5 and the 1992-4 surveys. Whether the increase in asthma prevalence represents an increase in disease presence or an increase in disease recognition cannot be determined from these data.