Association between adverse childhood experiences in the home and pediatric asthma

Ann Allergy Asthma Immunol. 2015 May;114(5):379-84. doi: 10.1016/j.anai.2015.02.019. Epub 2015 Apr 1.


Background: Numerous studies suggest that psychosocial factors could contribute to pediatric asthma.

Objective: To examine the relation between single and cumulative adverse childhood experiences (ACEs), a measurement of household dysfunction, on parent report of lifetime asthma in children.

Methods: This cross-sectional study used data from the 2011 to 2012 National Survey of Children's Health, a nationally representative sample of children 0 to 17 years old (n = 92,472). The main exposure was parent or guardian report of 6 ACE exposures (eg, witnessing domestic violence). The relation between ACE exposures and parent-reported diagnosis of childhood asthma was examined using multivariable logistic regression after controlling for demographic, socioeconomic, and behavioral covariates.

Results: Overall asthma prevalence was 14.6%. Exposure prevalence to any ACE was 29.2%. Increased number of ACE exposures was associated with increased odds of asthma. In the adjusted model, the odds of reporting asthma were 1.28 (95% confidence interval [CI] 1.14-1.43) for those reporting 1 ACE, 1.73 (95% CI 1.27-2.36) for those with 4 ACEs, and 1.61 (95% CI 1.15-2.26) for those with 5 or 6 ACEs compared with those with no ACE exposures. Effects were moderated by Hispanic ethnicity. Hispanic children exposed to 4 ACEs had a 4.46 times increase in lifetime asthma (95% CI 2.46-8.08); white children had a 1.19 times increase (95% CI 0.80-1.79) compared with those exposed to 0 ACE.

Conclusion: This study supports the growing evidence for the biopsychosocial model of asthma onset. Future studies should examine the association between ACEs and specific asthma-related health outcomes.

MeSH terms

  • Adolescent
  • Asthma / epidemiology*
  • Asthma / psychology*
  • Child
  • Child, Preschool
  • Cross-Sectional Studies
  • Female
  • Home Care Services
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Prevalence
  • Psychology
  • Stress, Psychological / complications*