Family size, atopic disorders in parents, asthma in children, and ethnicity,☆☆,,★★

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Abstract

Background: Several studies have reported an association between family size and atopic conditions, but few have found an association between asthma and family size. Objective: This study was designed to assess the effect of familial aggregation and sibling number on asthma in children. Methods: Children from 5 to 11 years of age in England and Scotland participated in a study in 1990 or 1991 in which responses to questions on asthma and wheezing in children and atopic conditions in parents were ascertained. Data on 11,924 complete family sets of child, mother, and father in three samples (the “representative” samples of England and Scotland and the English “inner city” sample) were analyzed. Results: The following factors were highly associated with child's asthma or wheezing: mother's or father's asthma or wheezing (with the same odds ratio [OR], 2.4; 95% confidence interval [CI], 2.0 to 2.9), other atopic condition in mothers and fathers (OR, 1.5; 95% CI, 1.3 to 1.8 and OR, 1.4; 95% CI, 1.2 to 1.7, respectively), and three or more siblings compared with no siblings (OR, 0.5; 95% CI, 0.4 to 0.6). Conclusion: The negative relation between family size and wheezing or asthma indicates a protective effect of number of children sharing an environment at a young age. The level of association of asthma or wheezing in the parents and the child and the association between the child's asthma or wheezing and other atopic conditions in parents suggest that a general susceptibility and a lung-specific susceptibility are important in the etiology of asthma. (J Allergy Clin Immunol 1997;99:454-60.)

Section snippets

Methods

The National Study of Health and Growth was a health surveillance system of primary school children. Information was obtained from English and Scottish samples on the basis of stratified random sampling of employment exchange areas with proportionally more study areas from poorer background and an English “inner city sample” selected by characteristics of deprivation and ethnic composition.15 The selection of the “inner city sample” was based on Small Area Statistics Census information from

Results

The total sample included 17,677 children; but of those, 11,924 (67%) had information on the family set (i.e., two parents and the child). Three thousand eight hundred forty-seven families were excluded from this analysis because of the lack of information for at least one atopic condition in both parents; 1373 families were excluded because of lack of information for at least one atopic condition in the father only; and 533 families were excluded because of lack of information on at least one

Discussion

This study has shown that parents' asthma or wheezing is highly associated with asthma or wheezing in their children, regardless of ethnicity. Other atopic conditions in parents such as eczema, rhinitis, and hay fever are independently associated with child's asthma; but the strength of the association was less than that for parental asthma or wheezing. These findings are consistent in all ethnic groups, except those originating from the Indian subcontinent. Prevalence of asthma or wheezing in

Acknowledgements

We thank our colleagues in the team and all parents, children, and helpers in the study areas.

References (27)

  • MF Moffatt et al.

    Genetic linkage of T-cell receptor alpha/gamma complex to specific IgE responses

    Lancet

    (1994)
  • WOCM Cookson et al.

    Maternal inheritance of IgE responsiveness on chromosome 11q

    Lancet

    (1992)
  • J. Pepys

    Recognition of the allergic phenotype. Natural history of “atopy”

    J Allergy Clin Immunol

    (1986)
  • MA Jenkins et al.

    The associations between childhood asthma and atopy, and parental asthma, hay fever and smoking

    Paediat Perinatal Epidemiol

    (1993)
  • YM Abdulrazzaq et al.

    Association of allergic symptoms in children with those in their parents

    Allergy

    (1994)
  • JB Davis et al.

    Atopy and wheeze in children according to parental atopy and family size

    Thorax

    (1981)
  • CIM Panhuysen et al.

    The genetics of asthma and atopy

    Allergy

    (1995)
  • DS Postma et al.

    Genetic susceptibility to asthma: bronchial hyperresponsiveness coinherited with a major gene for atopy

    N  Engl J Med

    (1995)
  • PGJ Burney et al.

    Has the prevalence of asthma increased in children? Evidence from the National Study of Health and Growth 1973-86

    BMJ

    (1990)
  • JK Peat et al.

    Changing prevalence of asthma in Australian children

    BMJ

    (1994)
  • E von Mutius et al.

    Skin test reactivity and number of siblings

    BMJ

    (1994)
  • J Crane et al.

    Asthma and having siblings [letter]

    BMJ

    (1994)
  • PGJ Burney

    Epidemiology

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    From the Division of Public Health Sciences, United Medical and Dental Schools, St. Thomas' Hospital, London.

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    Supported by the English Department of Health and the Scottish Home and Health Department.

    Reprint requests: R. J. Rona, Division of Public Health Sciences, UMDS, St Thomas' Hospital, London SE1 7EH, United Kingdom.

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