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Published ahead of print on November 21, 2002, doi:10.1164/rccm.200209-1063OC

Am. J. Respir. Crit. Care Med., Volume 167, Number 9, May 2003, 1239-1243

A more recent version of this article appeared on May 1, 2003
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Submitted on September 17, 2002
Accepted on November 16, 2002

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

Juan C Celedon1*, Rosalind J Wright1, Augusto A Litonjua1, Diane Sredl2, Louise Ryan3, Scott T Weiss4, and Diane R Gold1

1 Department of Medicine, Brigham and Women's Hospital, Channing Laboratory, Boston, MA, USA; Department of Medicine, Beth Israel Deaconess Medical Center, Division of Pulmonary and Critical Care Medicine, Boston, MA, USA; Harvard Medical School, Department of Medicine, Boston, MA, USA, 2 Department of Medicine, Brigham and Women's Hospital, Channing Laboratory, Boston, MA, USA, 3 Harvard School of Public Health, Department of Biostatistics, Boston, MA, USA; Dana-Farber Cancer Institute, Department of Medicine, Boston, MA, USA, 4 Department of Medicine, Brigham and Women's Hospital, Channing Laboratory, Boston, MA, USA; Harvard Medical School, Department of Medicine, Boston, MA, USA

* To whom correspondence should be addressed. E-mail: juan.celedon{at}channing.harvard.edu.

ABSTRACT 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 age 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 (OR=0.3, 95% 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 age 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 age 6 years but was instead associated with an increased risk of wheezing in the first six 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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