Dataset Information

Is the Association of Early Day Care Attendance with Childhood Asthma Explained by Underlying Susceptibility?

ABSTRACT:

Background

Previous studies of early day care attendance and asthma development are inconsistent, which may be explained by inadequate control of confounding and effect modification. We examined the effect of early day care on the risk of asthma taking into account the underlying susceptibility to asthma.

Methods

The study included 55,404 children participating in the Norwegian Mother, Father and Child Cohort Study. Asthma at age 7 was defined by dispensed asthma medications in the Norwegian Prescription Database. We defined a disease risk score (DRS) to account for an underlying susceptibility to asthma including a range of hereditary and nonhereditary predictors of asthma. We assessed confounding and modifying effects of DRS on the association between day care and asthma.

Results

Day care before 18 months was associated with a lower risk of asthma by age 7 (adjusted risk ratio [RR] = 0.85; 95% confidence interval [CI] = 0.78, 0.92) when compared with home care. DRS modified the estimated effect of day care on asthma risk. Among the 80% of children with DRS between 0.03 and 0.16, day care was associated with a reduced asthma risk (RRs between 0.79 and 0.87), whereas among 0.5% of children with a high DRS (above 0.28), estimated effect of day care on asthma increased gradually (RR for the highest DRS 2.2; 1.0-4.9).

Conclusions

In our study, among most children, early day care was associated with reduced asthma risk at 7 years, and increased risk in a small group of children with very high underlying susceptibility to asthma.

SUBMITTER: Rantala AK

PROVIDER: S-EPMC7144755 | biostudies-literature | 2020 May

REPOSITORIES: biostudies-literature

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Publications

Is the Association of Early Day Care Attendance with Childhood Asthma Explained by Underlying Susceptibility?

Rantala Aino K AK Magnus Maria C MC Karlstad Øystein Ø Stigum Hein H Håberg Siri E SE Nafstad Per P Nystad Wenche W Jaakkola Jouni J K JJK

Epidemiology (Cambridge, Mass.) 20200501 3

<h4>Background</h4>Previous studies of early day care attendance and asthma development are inconsistent, which may be explained by inadequate control of confounding and effect modification. We examined the effect of early day care on the risk of asthma taking into account the underlying susceptibility to asthma.<h4>Methods</h4>The study included 55,404 children participating in the Norwegian Mother, Father and Child Cohort Study. Asthma at age 7 was defined by dispensed asthma medications in th ...[more]

PMID: 31985502

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Project description:ImportanceEarly childhood interventions have demonstrated positive effects on well-being. Whether full-day vs part-day attendance improves outcomes is unknown.ObjectiveTo evaluate the association between a full- vs part-day early childhood program and school readiness, attendance, and parent involvement.Design, setting, and participantsEnd-of-preschool follow-up of a nonrandomized, matched-group cohort of predominantly low-income, ethnic minority children enrolled in the Child-Parent Centers (CPC) for the full day (7 hours; n = 409) or part day (3 hours on average; n = 573) in the 2012-2013 school year in 11 schools in Chicago, Illinois.InterventionThe Midwest CPC Education Program provides comprehensive instruction, family-support, and health services from preschool to third grade.Main outcomes and measuresSchool readiness skills at the end of preschool, attendance and chronic absences, and parental involvement. The readiness domains in the Teaching Strategies GOLD Assessment System include a total of 49 items with a score range of 105-418. The specific domains are socioemotional with 9 items (score range, 20-81), language with 6 items (score range, 15-54), literacy with 12 items (score range, 9-104), math with 7 items (score, 8-60), physical health with 5 items (score range, 14-45), and cognitive development with 10 items (score range, 18-90).ResultsFull-day preschool participants had higher scores than part-day peers on socioemotional development (58.6 vs 54.5; difference, 4.1; 95% CI, 0.5-7.6; P = .03), language (39.9 vs 37.3; difference, 2.6; 95% CI, 0.6-4.6; P = .01), math (40.0 vs 36.4; difference, 3.6; 95% CI, 0.5-6.7; P = .02), physical health (35.5 vs 33.6; difference, 1.9; 95% CI, 0.5-3.2; P = .006), and the total score (298.1 vs 278.2; difference, 19.9; 95% CI, 1.2-38.4; P = .04). Literacy (64.5 vs 58.6; difference, 5.9; 95% CI, -0.07 to 12.4; P = .08) and cognitive development (59.7 vs 57.7; difference, 2.0; 95% CI, -2.4 to 6.3; P = .38) were not significant. Full-day preschool graduates also had higher rates of attendance (85.9% vs 80.4%; difference, 5.5; 95% CI, 2.6-8.4; P = .001) and lower rates of chronic absences (≥10% days missed; 53.0% vs 71.6%; difference, -18.6; 95% CI, -28.5 to -8.7; P = .001; ≥20% days missed; 21.2% vs 38.8%; difference -17.6%; 95% CI, -25.6 to -9.7; P < .001) but no differences in parental involvement.Conclusions and relevanceIn an expansion of the CPCs in Chicago, a full-day preschool intervention was associated with increased school readiness skills in 4 of 6 domains, attendance, and reduced chronic absences compared with a part-day program. These findings should be replicated in other programs and contexts.

Dataset Information

Is the Association of Early Day Care Attendance with Childhood Asthma Explained by Underlying Susceptibility?

Background

Methods

Results

Conclusions

Publications

Is the Association of Early Day Care Attendance with Childhood Asthma Explained by Underlying Susceptibility?

Similar Datasets

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