Association between Asthma and Developmental Disability and Delay in the United States Pediatric Population

Abstract

Background. To date, few studies have systemically examined the association between asthma and various developmental disabilities and delays among pediatric populations. To address this scientific gap, we report here the asthma prevalence estimates by, and associations with, various disability categories and developmental delay in the United States (US) pediatric population. Methods: A total of 71 811 families with children/adolescents aged 0-to-17 years old who participated in the 2016-2017 National Survey of Children’s Health were included in this cross-sectional analytical sample. Weighted asthma prevalence estimates were calculated and compared between children with and without disabilities or delays. Disabilities included Attention-Deficit/Hyperactivity Disorder, Autism Spectrum Disorder, Cerebral Palsy, seizure, vision, hearing and speech, intellectual-, and learning disability. Delay was defined as not meeting growth milestones with unknown cause. Logistic regression analysis generated the odds of an asthma diagnosis by disability status adjusted for demographics and birth weight. Findings: Overall asthma prevalence estimates were 10% higher in children with a disability (~16%) versus children without a disability (~6%) (p<0·0001). The risk of asthma was nearly three times higher in children with a disability versus children with no disability (Odds Ratio [OR] 2·77, 95% Confidence Interval [CI] 2·39-3·21, p<0·0001) and two times higher among children with a developmental delay versus their peers with no delay (OR 2·22, 95% CI, 1·78-2·77, p<0·0001). Adjusted models remained significant for all disability categories (overall adjusted OR [aOR] 2·21, 95% CI 1·87-2·62, p<0.0001). Subgroup analyses showed ethnic minorities had a higher prevalence of concurrent asthma and developmental disabilities versus non-Hispanic whites. Interpretation: Results suggest that US children with various developmental disabilities or delay are at higher odds for asthma versus their typically developing peers. These findings support asthma screening in pediatric healthcare settings among patients with developmental disabilities and delays, and particularly among those from ethnic minority backgrounds. Funding Statement: This study was not supported by any funding. Declaration of Interests: All authors declare no competing interests. Ethics Approval Statement: Our research was exempted from the University of Texas Institutional Review Board approval process because it is publicly available data.