Parental History and the Risk for Childhood Asthma

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Abstract
Although heredity plays a major role in asthma and in other allergic diseases, mechanisms underlying the inheritance of these disorders are poorly understood, as is the relative contribution of maternal and paternal conditions to risk of disease. We investigated doctor-diagnosed maternal and paternal asthma, eczema, and hay fever as cross-sectional predictors of childhood asthma and allergic disease in 306 children with a median age of 3.5 yr from families in which at least one parent had a history of either asthma or other allergic conditions. For both childhood asthma and eczema, the strongest parental predictors were the same conditions in the parents. For asthma in particular, maternal asthma was most strongly associated with asthma in the child over all ages in both univariate (OR = 3.2, 95% CI = 1.5 to 6.7) and multivariable (OR = 4.1, 95% CI = 1.7 to 10.1) models. Paternal asthma was weakly associated with childhood asthma in the univariate model (OR = 1.4, 95% CI = 0.6 to 3.2), but this association increased in magnitude in the multivariable model (OR = 2.7, 95% CI = 1.0 to 7.2). Among the children < 5 yr of age, the risk for childhood asthma associated with maternal asthma (OR = 5.0, 95% CI = 1.7 to 14.9) was greater than the risk associated with paternal asthma (OR = 1.6, 95% CI = 0.5 to 5.9), whereas both maternal asthma and paternal asthma were associated with similar risks among children ⩾ 5 yr of age (OR = 4.6, 95% CI = 1.1 to 19.0 and OR = 4.1, 95% CI = 1.0 to 16.0, respectively). The odds of having a child with asthma were three times greater in families with one asthmatic parent and six times greater in families with two asthmatic parents than in families where only one parent had inhalant allergy without asthma; furthermore, inhalant allergy in one parent also conferred additional risk in the presence of asthma in the other parent. Further investigation is needed into the relative importance of genetic factors and in utero and postnatal exposures in determining the differential effects of maternal and paternal asthma on the development of childhood asthma.