Mother's education and offspring asthma risk in 10 European cohort studies

Kate Marie Lewis¹, Milagros Ruiz¹, Peter Goldblatt², Joana Morrison¹, Daniela Porta³, Francesco Forastiere³, Daniel Hryhorczuk⁴, Oleksandr Zvinchuk⁵, Marie-Josephe Saurel-Cubizolles⁶, Sandrine Lioret⁷, Isabella Annesi-Maesano⁸, Martine Vrijheid^{9

10

11}, Maties Torrent^{11

12}, Carmen Iniguez^{11

13}, Isabel Larranaga^{14

15}, Margreet W Harskamp-van Ginkel¹⁶, Tanja G M Vrijkotte¹⁶, Jana Klanova^{17

18}, Jan Svancara¹⁸, Henrique Barross^{19

20}, Sofia Correia^{19

20}, Marjo-Riitta Jarvelin^{21

22

23

24}, Anja Taanila²⁴, Johnny Ludvigsson²⁵, Tomas Faresjo²⁶, Michael Marmot^{1

2}, Hynek Pikhart²⁷

Affiliations

¹ Research Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London, WC1E 6BT, UK.
² Research Department of Epidemiology and Public Health, UCL Institute of Health Equity, University College London, London, UK.
³ Department of Epidemiology, Lazio Regional Health System, Rome, Italy.
⁴ Center for Global Health, University of Illinois College of Medicine, Chicago, IL, USA.
⁵ Institute of Pediatrics, Obstetrics, and Gynecology, National Academy of Medical Sciences of Ukraine, Kiev, Ukraine.
⁶ Institut National de la Santé et de la Recherche Médicale (INSERM), UMR 1153, Obstetrical, Perinatal and Pediatric Epidemiology Research Team (Epopé), Center for Epidemiology and Statistics, Sorbonne Paris Cité, DHU Risks in Pregnancy, Paris Descartes University, Paris, France.
⁷ Institut National de la Santé et de la Recherche Médicale (INSERM), UMR 1153, Early Origin of the Child's Health and Development Team (ORCHAD), Center for Epidemiology and Statistics, Sorbonne Paris Cité, Paris Descartes University, Paris, France.
⁸ Pierre Louis Institute of Epidemiology and Public Health (iPLESP), UMR 1136, Epidemiology of Allergic and Respiratory Diseases (EPAR), Paris, France.
⁹ ISGlobal, Center for Research in Environmental Epidemiology (CREAL), Barcelona, Spain.
¹⁰ Universitat Pompeu Fabra (UPF), Barcelona, Spain.
¹¹ Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Barcelona, Spain.
¹² IB-Salut Menorca Health Area, Balearic Islands, Spain.
¹³ Joint Research Unit of Epidemiology and Environmental Health, FISABIO - Universitat Jaume I - Universitat de Valéncia, Castellón de la Plana, Spain.
¹⁴ Public Health Department of Gipuzkoa, Gipuzkoa, Spain.
¹⁵ BIODONOSTIA Health Research Institute, San Sebastian, Spain.
¹⁶ Department of Public Health, Amsterdam Public Health Research Institute, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
¹⁷ Research Centre of Toxic Compounds in the Environment (RECETOX), Faculty of Science, Masaryk University, Brno, Czech Republic.
¹⁸ Institute of Biostatistics and Analyses (IBA), Masaryk University, Brno, Czech Republic.
¹⁹ EPIUnit - Institute of Public Health, University of Porto, Porto, Portugal.
²⁰ Department of Clinical Epidemiology, Predictive Medicine and Public Health, University of Porto Medical School, Porto, Portugal.
²¹ Department of Epidemiology and Biostatistics, MRC Health Protection Agency (HPE), Centre for Environment and Health, School of Public Health, Imperial College London, London, UK.
²² Biocenter Oulu, University of Oulu, Oulu, Finland.
²³ Unit of Primary Care, Oulu University Hospital, Oulu, Finland.
²⁴ Faculty of Medicine, Center for Life Course Health Research, University of Oulu, Oulu, Finland.
²⁵ Division of Pediatrics, Department of Clinical and Experimental Medicin, Linköping University, Linköping, Sweden.
²⁶ Department of Medicine and Health, Community Medicine/General Practice Faculty of Health Sciences, Linköping University, Linköping, Sweden.
²⁷ Research Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London, WC1E 6BT, UK. h.pikhart@ucl.ac.uk.

PMID: 28929268
PMCID: PMC5662657
DOI: 10.1007/s10654-017-0309-0

Comparative Study

Mother's education and offspring asthma risk in 10 European cohort studies

Kate Marie Lewis et al. Eur J Epidemiol. 2017 Sep.

. 2017 Sep;32(9):797-805.

doi: 10.1007/s10654-017-0309-0. Epub 2017 Sep 19.

Authors

Affiliations

¹ Research Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London, WC1E 6BT, UK.
² Research Department of Epidemiology and Public Health, UCL Institute of Health Equity, University College London, London, UK.
³ Department of Epidemiology, Lazio Regional Health System, Rome, Italy.
⁴ Center for Global Health, University of Illinois College of Medicine, Chicago, IL, USA.
⁵ Institute of Pediatrics, Obstetrics, and Gynecology, National Academy of Medical Sciences of Ukraine, Kiev, Ukraine.
⁶ Institut National de la Santé et de la Recherche Médicale (INSERM), UMR 1153, Obstetrical, Perinatal and Pediatric Epidemiology Research Team (Epopé), Center for Epidemiology and Statistics, Sorbonne Paris Cité, DHU Risks in Pregnancy, Paris Descartes University, Paris, France.
⁷ Institut National de la Santé et de la Recherche Médicale (INSERM), UMR 1153, Early Origin of the Child's Health and Development Team (ORCHAD), Center for Epidemiology and Statistics, Sorbonne Paris Cité, Paris Descartes University, Paris, France.
⁸ Pierre Louis Institute of Epidemiology and Public Health (iPLESP), UMR 1136, Epidemiology of Allergic and Respiratory Diseases (EPAR), Paris, France.
⁹ ISGlobal, Center for Research in Environmental Epidemiology (CREAL), Barcelona, Spain.
¹⁰ Universitat Pompeu Fabra (UPF), Barcelona, Spain.
¹¹ Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Barcelona, Spain.
¹² IB-Salut Menorca Health Area, Balearic Islands, Spain.
¹³ Joint Research Unit of Epidemiology and Environmental Health, FISABIO - Universitat Jaume I - Universitat de Valéncia, Castellón de la Plana, Spain.
¹⁴ Public Health Department of Gipuzkoa, Gipuzkoa, Spain.
¹⁵ BIODONOSTIA Health Research Institute, San Sebastian, Spain.
¹⁶ Department of Public Health, Amsterdam Public Health Research Institute, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
¹⁷ Research Centre of Toxic Compounds in the Environment (RECETOX), Faculty of Science, Masaryk University, Brno, Czech Republic.
¹⁸ Institute of Biostatistics and Analyses (IBA), Masaryk University, Brno, Czech Republic.
¹⁹ EPIUnit - Institute of Public Health, University of Porto, Porto, Portugal.
²⁰ Department of Clinical Epidemiology, Predictive Medicine and Public Health, University of Porto Medical School, Porto, Portugal.
²¹ Department of Epidemiology and Biostatistics, MRC Health Protection Agency (HPE), Centre for Environment and Health, School of Public Health, Imperial College London, London, UK.
²² Biocenter Oulu, University of Oulu, Oulu, Finland.
²³ Unit of Primary Care, Oulu University Hospital, Oulu, Finland.
²⁴ Faculty of Medicine, Center for Life Course Health Research, University of Oulu, Oulu, Finland.
²⁵ Division of Pediatrics, Department of Clinical and Experimental Medicin, Linköping University, Linköping, Sweden.
²⁶ Department of Medicine and Health, Community Medicine/General Practice Faculty of Health Sciences, Linköping University, Linköping, Sweden.
²⁷ Research Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London, WC1E 6BT, UK. h.pikhart@ucl.ac.uk.

PMID: 28929268
PMCID: PMC5662657
DOI: 10.1007/s10654-017-0309-0

Abstract

Highly prevalent and typically beginning in childhood, asthma is a burdensome disease, yet the risk factors for this condition are not clarified. To enhance understanding, this study assessed the cohort-specific and pooled risk of maternal education on asthma in children aged 3-8 across 10 European countries. Data on 47,099 children were obtained from prospective birth cohort studies across 10 European countries. We calculated cohort-specific prevalence difference in asthma outcomes using the relative index of inequality (RII) and slope index of inequality (SII). Results from all countries were pooled using random-effects meta-analysis procedures to obtain mean RII and SII scores at the European level. Final models were adjusted for child sex, smoking during pregnancy, parity, mother's age and ethnicity. The higher the score the greater the magnitude of relative (RII, reference 1) and absolute (SII, reference 0) inequity. The pooled RII estimate for asthma risk across all cohorts was 1.46 (95% CI 1.26, 1.71) and the pooled SII estimate was 1.90 (95% CI 0.26, 3.54). Of the countries examined, France, the United Kingdom and the Netherlands had the highest prevalence's of childhood asthma and the largest inequity in asthma risk. Smaller inverse associations were noted for all other countries except Italy, which presented contradictory scores, but with small effect sizes. Tests for heterogeneity yielded significant results for SII scores. Overall, offspring of mothers with a low level of education had an increased relative and absolute risk of asthma compared to offspring of high-educated mothers.

Keywords: Asthma; Children; Cohort studies; Disease risk; Maternal education; Socioeconomic position.

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Conflict of interest statement

The authors declare that they have no conflict of interests.

Figures

**Fig. 1**
Forest plots of the RII (a) and SII (b) in childhood asthma across 10 European cohorts (*squares*) and combined (*diamond*), adjusted for child sex, smoking during pregnancy, parity, mother’s age and ethnicity; values to the right of the *undashed vertical line* indicate greater inequity for low compared to high maternal education groups

See this image and copyright information in PMC

References

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Mother's education and offspring asthma risk in 10 European cohort studies

Affiliations

Mother's education and offspring asthma risk in 10 European cohort studies

Authors

Affiliations

Abstract

Conflict of interest statement

Figures

References

Publication types

MeSH terms

Grants and funding

LinkOut - more resources

Full Text Sources

Other Literature Sources

Medical