Associations Between Asthma and Puberty in Swedish Children

Abstract

The evidence relating to asthma, puberty and growth is conflicting. Using data from a longitudinal, population-based, asthma-centric cohort of Swedish singletons (born 1994-1996), we sought to 1 consider the association between pubertal staging and asthma (presence, timing, severity, treatment), and 2 examine if the use of asthma medications influences pubertal staging and height. At Yr8 and Yr12, anthropometric data were collected, as were data on asthma (presence, symptoms, management) in the previous 12 months. At Yr12, children answered puberty-related questions. Retention through Yr12 was high (3339/4089 [82%]). We excluded 593 for whom pubertal data were not available, yielding a study population of 2746 (50.2% boys). Nearly all (97.8%) boys were pre, early or mid-pubertal, and almost half (47.6%) of girls were late/post pubertal. At Yr8, 7.3% boys and 5.2% girls had asthma. At Yr12, 84% boys and 4.9% girls had asthma. Amongst girls, late/post puberty was associated with a reduced odds of asthma at Yr12 (OR 0.23; 95%CI 0.09-0.60) and incident asthma (OR 0.17; 95%CI 0.05-0.52). Amongst boys, inhaled corticosteroids use with or without long-acting ß-agonists, was cross-sectionally associated with shorter height vs. asthma medications/bronchodilators only at Yr12 (ß-4.32, 95%CI -8.20 - -0.43, p<0.01). Girls who enter puberty earlier have a lower risk of asthma by the time they reach late/post puberty. Boys who use ICS or ICSLABA tend to be shorter at ages 11.4-14.3 years than boys with asthma who do not use asthma medications or use bronchodilators only.