Late Breaking Abstract - Identifying preventable early risk factors for asthma in Indigenous children: a population cohort study in Western Australia

Abstract

Background: Australia has one of the highest asthma rates worldwide and the Indigenous population carry a high burden, yet little is known about the role of perinatal risk determinants on asthma in Indigenous children. Aim: To identify and quantify potentially preventable risk factors for asthma in Indigenous children. Methods: Indigenous children born 2000-2013 in Western Australia were identified using linkage of birth data, hospital and emergency data (n = 32 333). Asthma was identified from hospitalisation codes. Odds ratios (OR) and population attributable fractions were calculated for maternal age at birth, parity, remoteness, area-level disadvantage, prematurity, low birth weight, maternal smoking in pregnancy, mode of delivery, maternal trauma and hospitalisations for acute respiratory tract infection (ARTI) in the first year of life. Potential confounders were identified using directed acyclic graphs. Results: There were 705 (2.8%) children hospitalised for asthma between the ages of 1 - 5 years. Risk factors associated with asthma included: being hospitalised for an ARTI (OR 4.06, 95%CI 3.44,4.78), area-level disadvantage (OR 1.58, 95%CI 1.28,1.94), being born Conclusion: Improving care for pregnant Indigenous women and infants with wheezing illnesses may help to reduce the burden of asthma in the Indigenous population.