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Birth order, atopy, and symptoms of allergy and asthma among inner-city children attending Head Start in New York City.
Clin Exp Allergy. 2008 Jun; 38(6):968-76.CE

Abstract

BACKGROUND

In past research, children with older siblings were more likely than others to wheeze at age 2 years, but less likely by age 6 years. Higher infection transmission and a down-regulated allergic immune response as a result of these infections, respectively, were suggested as the causes. However, in a study of children aged 0-3 years in a low-income urban community in New York City, USA, with high asthma prevalence, we observed no birth-order effect.

OBJECTIVE

To evaluate the association between birth order and atopy and respiratory symptoms in 4-year-old children attending Head Start programs in NYC.

METHODS

Respiratory symptoms were assessed by questionnaire for 1005 children (mean age 4.0 years) living in high asthma prevalence neighbourhoods. Serum was collected from a subgroup of the children (n=494) and specific IgE responses to dust mite, cockroach, mouse, and cat allergens were measured.

RESULTS

Prevalence of specific IgE (> or =0.35 IU/mL) did not differ significantly among first (35%), second (35%), and later-born children (28%) (P=0.23). Increasing birth order was associated with increasing prevalence of respiratory symptoms in the prior year, including wheeze (first 20%, second 27%, third or later 35%; P<0.001), being awakened at night by cough (28%, 33%, 38%; P=0.005), emergency department visits (14%, 17%, 21%; P=0.02) and hospitalizations for difficulty breathing (6.1%, 6.6%, 10%; P=0.04). The associations of birth order with respiratory symptoms were statistically significant only for the non-seroatopic children and those without an asthmatic parent.

CONCLUSIONS

Non-seroatopic children with older siblings were more likely than those without older siblings to have respiratory symptoms at age 4 years. Although the stability of these associations over time remains to be determined, the differences in findings between this study and our previous NYC birth cohort study suggest that patterns of asthma development may vary even among low-income populations within the same city.

Authors+Show Affiliations

Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY 10032, USA. mp2217@columbia.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

18355370

Citation

Perzanowski, M S., et al. "Birth Order, Atopy, and Symptoms of Allergy and Asthma Among Inner-city Children Attending Head Start in New York City." Clinical and Experimental Allergy : Journal of the British Society for Allergy and Clinical Immunology, vol. 38, no. 6, 2008, pp. 968-76.
Perzanowski MS, Canfield SM, Chew GL, et al. Birth order, atopy, and symptoms of allergy and asthma among inner-city children attending Head Start in New York City. Clin Exp Allergy. 2008;38(6):968-76.
Perzanowski, M. S., Canfield, S. M., Chew, G. L., Mellins, R. B., Hoepner, L. A., Jacobson, J. S., & Goldstein, I. F. (2008). Birth order, atopy, and symptoms of allergy and asthma among inner-city children attending Head Start in New York City. Clinical and Experimental Allergy : Journal of the British Society for Allergy and Clinical Immunology, 38(6), 968-76. https://doi.org/10.1111/j.1365-2222.2008.02967.x
Perzanowski MS, et al. Birth Order, Atopy, and Symptoms of Allergy and Asthma Among Inner-city Children Attending Head Start in New York City. Clin Exp Allergy. 2008;38(6):968-76. PubMed PMID: 18355370.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Birth order, atopy, and symptoms of allergy and asthma among inner-city children attending Head Start in New York City. AU - Perzanowski,M S, AU - Canfield,S M, AU - Chew,G L, AU - Mellins,R B, AU - Hoepner,L A, AU - Jacobson,J S, AU - Goldstein,I F, Y1 - 2008/03/18/ PY - 2008/3/22/pubmed PY - 2008/7/29/medline PY - 2008/3/22/entrez SP - 968 EP - 76 JF - Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology JO - Clin Exp Allergy VL - 38 IS - 6 N2 - BACKGROUND: In past research, children with older siblings were more likely than others to wheeze at age 2 years, but less likely by age 6 years. Higher infection transmission and a down-regulated allergic immune response as a result of these infections, respectively, were suggested as the causes. However, in a study of children aged 0-3 years in a low-income urban community in New York City, USA, with high asthma prevalence, we observed no birth-order effect. OBJECTIVE: To evaluate the association between birth order and atopy and respiratory symptoms in 4-year-old children attending Head Start programs in NYC. METHODS: Respiratory symptoms were assessed by questionnaire for 1005 children (mean age 4.0 years) living in high asthma prevalence neighbourhoods. Serum was collected from a subgroup of the children (n=494) and specific IgE responses to dust mite, cockroach, mouse, and cat allergens were measured. RESULTS: Prevalence of specific IgE (> or =0.35 IU/mL) did not differ significantly among first (35%), second (35%), and later-born children (28%) (P=0.23). Increasing birth order was associated with increasing prevalence of respiratory symptoms in the prior year, including wheeze (first 20%, second 27%, third or later 35%; P<0.001), being awakened at night by cough (28%, 33%, 38%; P=0.005), emergency department visits (14%, 17%, 21%; P=0.02) and hospitalizations for difficulty breathing (6.1%, 6.6%, 10%; P=0.04). The associations of birth order with respiratory symptoms were statistically significant only for the non-seroatopic children and those without an asthmatic parent. CONCLUSIONS: Non-seroatopic children with older siblings were more likely than those without older siblings to have respiratory symptoms at age 4 years. Although the stability of these associations over time remains to be determined, the differences in findings between this study and our previous NYC birth cohort study suggest that patterns of asthma development may vary even among low-income populations within the same city. SN - 1365-2222 UR - https://www.unboundmedicine.com/medline/citation/18355370/Birth_order_atopy_and_symptoms_of_allergy_and_asthma_among_inner_city_children_attending_Head_Start_in_New_York_City_ L2 - https://doi.org/10.1111/j.1365-2222.2008.02967.x DB - PRIME DP - Unbound Medicine ER -