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Day Care Attendance in Early Life, Maternal History of Asthma, and Asthma at the Age of 6 Years

Channing Laboratory, Department of Medicine, Brigham and Women's Hospital; Division of Pulmonary and Critical Care Medicine, Beth Israel Deaconess Medical Center; Harvard Medical School; Department of Biostatistics, Harvard School of Public Health, and Dana-Farber Cancer Institute, Boston, Massachusetts

Correspondence and requests for reprints should be addressed to Juan C. Celedón, M.D., D.P.H., Channing Laboratory, 181 Longwood Avenue, Boston, MA 02115. E-mail: juan.celedon{at}channing.harvard.edu

Among children not selected on the basis of a parental history of atopy, day care attendance in early life is inversely associated with asthma at school age. We examined the relation between day care in the first year of life and asthma, recurrent wheezing, and eczema at the age of 6 years and wheezing in the first 6 years of life among 453 children with parental history of atopy followed from birth. Among all study participants, day care in the first year of life was inversely associated with eczema (odds ratio [OR] = 0.3, 95% confidence interval [CI] = 0.1–0.8). Day care attendance in early life was associated with a decreased risk of asthma (OR = 0.3, 95% CI = 0.1–0.7) and recurrent wheezing (OR = 0.3, 95% CI = 0.1–0.9) at the age of 6 years and with a decreased risk of any wheezing after the age of 4 years only among children without maternal history of asthma. Among children with maternal history of asthma, day care in early life had no protective effect on asthma or recurrent wheezing at the age of 6 years but was instead associated with an increased risk of wheezing in the first 6 years of life. Our findings suggest that maternal history of asthma influences the relation between day care–related exposures and childhood asthma.

Key Words: day care • maternal history • asthma

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