Parental educational level and childhood wheezing and asthma: A prospective cohort study from the Japan Environment and Children's Study.

Yasuaki Saijo,Yoshiya Ito,Sachiko Itoh,Keiko Yamazaki,Atsuko Araki,Eiji Yoshioka,Yukihiro Sato,Sumitaka Kobayashi,Machiko Minatoya,Reiko Kishi,Toshinobu Miyamoto,Chihiro Miyashita,Yusuke Tanahashi,Hiroshi Azuma,Yu Ait Bamai,Maria Christine Magnus

doi:10.1371/journal.pone.0250255

Abstract

BackgroundThe influence of mothers’ and fathers’ educational levels in separate evaluations of asthma has not been fully investigated. This study aims to examine the associations of the mother’s and fathers’ educational levels with childhood wheeze and asthma adjusting for crude and pre-and post-natal modifiable risk factors.MethodsWe conducted a prospective cohort study using data from the Japan Environment and Children’s Study, which recruited pregnant women from 2011 to 2014. The mother’s and father’s educational levels were surveyed by a questionnaire during the pregnancy, and childhood wheezing and doctor-diagnosed asthma were estimated using a 3-year questionnaire. Multilevel logistic regression analysis was performed to evaluate the association between the mother’s and father’s educational levels and childhood wheezing and asthma, adjusted for pre-and post-natal factors.ResultsA total of 69,607 pairs of parents and their single infants were analyzed. We found 17.3% of children had wheezing and 7.7% had asthma. In crude analyses, lower educational level of parents was associated with an increased risk of childhood wheezing and asthma. After full adjustment, a lower educational level of mothers was associated with an increased risk of childhood asthma (junior high school (reference: high school); odds ratio (OR): 1.17, 95% CI, 1.01–1.36), and higher educational level, especially the mother’s, was associated with an increased risk of childhood wheezing (technical junior college, technical/vocational college, or associate degree (ECD3); OR: 1.12, 95% CI, 1.06–1.18, bachelor’s degree, or postgraduate degree; OR: 1.10, 95% CI, 1.03–1.18), and asthma (ECD3; OR: 1.13, 95% CI, 1.04–1.21).ConclusionsParents’ lower educational level was a crude risk factor for childhood wheezing and asthma. However, an increased risk of wheezing due to mothers’ higher educational level was found after adjusting for pre-and post-natal factors.

Highlights

Asthma is a common non-communicable disease affecting people of all ages around the world, and it has a substantial burden of disease like premature death and reduced quality of life [1]
Lower educational level of parents was associated with an increased risk of childhood wheezing and asthma
A lower educational level of mothers was associated with an increased risk of childhood asthma (junior high school; odds ratio (OR): 1.17, 95%

Summary

Introduction

Asthma is a common non-communicable disease affecting people of all ages around the world, and it has a substantial burden of disease like premature death and reduced quality of life [1]. Several studies reported that lower mother’s educational level (no evaluation of father’s educational level) was associated with childhood asthma [7,8,9], but no association was reported after adjusting for post-natal factors including breastfeeding [10]. A study that measured both mothers’ and fathers’ educational levels reported that only lower paternal educational level had a significant relationship without postnatal factor adjustment [13]. One Japanese study reported no significant relationship of both mother’s and father’s educational levels with pre- and postnatal factors adjustment [14]. This study aims to examine the associations of the mother’s and fathers’ educational levels with childhood wheeze and asthma adjusting for crude and pre-and post-natal modifiable risk factors

Objectives

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Results

Conclusion