Background: Symptoms of asthma start early in human life, important life and environmental factors cannot be studied in detail if the participants are preschool children or older. Aims: To investigate the early risk factors for childhood asthma and to develop a predictive model for the development of asthma by birth cohort study. Methods: A representative sample of mother-newborn pairs was obtained by multistage, stratified systematic sampling from the Taiwan national birth register in 2005. Home interviews at 6 months and 5 years of age were conducted to inquire potential risk factors and children's health status, respectively. Multivariate regression analysis was used to determine the risk factors for children asthma in predictive models. Area-under-curve (AUC) statistic from receiver-operating characteristic curve analysis was used to compare the ability of models to discriminate between children with and without asthma. Results: A total of 19,192 mother-newborn pairs completed the study satisfactorily. The prevalence of physician-diagnose asthma was 7.6% in boys and 5.5% in girls, respectively. Prenatal (parental atopy and socioeconomic status), perinatal (resident area and painting wall during pregnancy), and postnatal factors (mother with postpartum stress and children with atopic dermatitis (AD) before 6 months old) were chosen in predictive models by backward stepwise analysis. The highest predicted probability of asthma was 68.1% in boys and 76.1% in girls with above factors. The lowest probability was 7.7%, among boys and girls with none of above factors, respectively. Compared with AUCs of prenatal factor model and the model adding perinatal factors, model more adding postnatal factors provided significantly higher ability to discriminate between children with and without asthma. Conclusions: This investigation provides technique for predicting risk of childhood asthma by prenatal, perinatal, and postnatal factors that can be used for developing preventive strategy against asthma, especially among those children with AD and family history of atopy.
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