ArticleThorax2022
Disadvantage in early-life and persistent asthma in adolescents: a UK cohort study.
Article in Thorax, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 2 of them syntheses that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
12 citing papers in PubMed, 2 syntheses or guidelines pooled it, 23 citations in OpenAlex.
- The influence of disparities on intensive care outcomes in children with respiratory diseases: A systematic review.Pediatric pulmonology · 2024Pooled it
- Mediators of socioeconomic inequalities in preterm birth: a systematic review.BMC public health · 2022Pooled it
- Engagement and Intersectionality in Digital Self-Management Interventions for Asthma and Chronic Obstructive Pulmonary Disease: Scoping Review.Journal of medical Internet research · 2026Article
- Early life factors and genetic interactions in allergic rhinitis: a genome-wide study.BMC pediatrics · 2026Article
- Article
- ERS Congress 2024: highlights from the Paediatrics Assembly.ERJ open research · 2025Article
- Social inequalities in childhood asthma.The World Allergy Organization journal · 2024Review
- Contribution of ethnicity, area level deprivation and air pollution to paediatric intensive care unit admissions in the United Kingdom 2008-2021.EClinicalMedicine · 2024Article
- How to assess whether a complex intervention for chronic conditions is cost-effective?The Lancet regional health. Europe · 2024Article
- Differences between parents' and paediatricians' perceptions of mild respiratory infections in childhood: contrast study.Frontiers in public health · 2024Article
- Assessing the value of integrating national longitudinal shopping data into respiratory disease forecasting models.Nature communications · 2023Article
- Article
Corrections and comments
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Authors and funding
7 authors at 3 institutions in 2 countries.
Funding
Abstract
objectiveTo determine how early-life risk factors explain socioeconomic inequalities in persistent asthma in adolescence.
methodsWe did a causal mediation analysis using data from 7487 children and young people in the UK Millennium Cohort Study. Persistent asthma was defined as having a diagnosis reported at any two or more time points at 7, 11 or 14 years. The main exposure was maternal education, a measure of early-life socioeconomic circumstances (SECs), used to calculate the relative index of inequality. We assessed how blocks of perinatal (maternal health behaviours, infant characteristics and duration of breastfeeding, measured at 9 months) and environmental risk factors (family housing conditions; potential exposure to infections through childcare type and sibling number, and neighbourhood characteristics, measured at 3 years) mediated the total effect of childhood SECs on persistent asthma risk, calculating the proportion mediated and natural indirect effect (NIE) via blocks of mediators.
resultsAt age 14 the overall prevalence of persistent asthma was 15%. Children of mothers with lower educational qualifications were more likely to have persistent asthma, with a clear social gradient (degree plus: 12.8% vs no qualifications: 20.3%). The NIE gives the effect of SECs acting only via the mediators and shows a 31% increased odds of persistent asthma when SECs are fixed at the highest level, and mediators at the level which would naturally occur at the lowest SECs versus highest SECs (NIE OR 1.31, 95% CI 1.04 to 1.65). Overall, 58.9% (95% CI 52.9 to 63.7) of the total effect (OR 1.70, 95% CI 1.20 to 2.40) of SECs on risk of persistent asthma in adolescence was mediated by perinatal and environmental characteristics.
conclusionsPerinatal characteristics and the home environment in early life are more important in explaining socioeconomic inequalities in persistent asthma in British adolescents than more distal environmental exposures outside the home.
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Registered trials
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