TY - JOUR
T1 - Tobacco smoke exposure and allergic sensitization in children
T2 - A propensity score analysis
AU - Havstad, Suzanne L.
AU - Johnson, Christine Cole
AU - Zoratti, Edward M.
AU - Ezell, Jerel M.
AU - Woodcroft, Kimberly
AU - Ownby, Dennis R.
AU - Wegienka, Ganesa
PY - 2012/10
Y1 - 2012/10
N2 - Background and objective: There is conflicting evidence of the effect of environmental tobacco smoke (ETS) on the development of allergic diseases in children. Studies have shown that this relationship differs depending on maternal history of the disease. We employed the rigour of propensity score methods to assess this relationship using data from a birth cohort. Methods: Using n = 662 children from the Wayne County Health, Environment, Allergy and Asthma Longitudinal Study, we assessed the relationship between early-life ETS and subsequent allergic sensitization via a positive skin prick test (SPT+) or at least one specific immunoglobulin E (IgE) ≥ 0.35 (sIgE+) in children aged 2-3 years. Propensity score estimation followed by full and nearest neighbour matching was compared with standard multivariable regression models. Results: Among children without a maternal history of allergic disease, ETS was positively associated with allergic sensitization in children with an adjusted odds ratio (aOR) for SPT+ of 2.32 (95% confidence interval (CI): 1.28-4.22) and the aOR for sIgE+ was 2.53 (95% CI: 1.43-4.48). Contrarily, for children with a positive maternal history, the aOR for SPT+ and sIgE+ was 0.56 (95% CI: 0.24-1.32) and 0.43 (95% CI: 0.20-0.91), respectively. Conclusions: Using propensity score methods to rigorously control for confounding factors, ETS exposure was found to reduce the risk of allergic sensitization in children with a positive maternal history. There is a strong association between early-life ETS and the development of allergic sensitization for children aged 2-3 years without maternal history. Using propensity score methods to rigorously control for confounding factors, we found that early-life exposure to household tobacco smoke reduces the risk of allergic sensitization in children with a maternal history of allergy/asthma. However, there is a strong increased risk for children aged 2-3 years without a maternal history.
AB - Background and objective: There is conflicting evidence of the effect of environmental tobacco smoke (ETS) on the development of allergic diseases in children. Studies have shown that this relationship differs depending on maternal history of the disease. We employed the rigour of propensity score methods to assess this relationship using data from a birth cohort. Methods: Using n = 662 children from the Wayne County Health, Environment, Allergy and Asthma Longitudinal Study, we assessed the relationship between early-life ETS and subsequent allergic sensitization via a positive skin prick test (SPT+) or at least one specific immunoglobulin E (IgE) ≥ 0.35 (sIgE+) in children aged 2-3 years. Propensity score estimation followed by full and nearest neighbour matching was compared with standard multivariable regression models. Results: Among children without a maternal history of allergic disease, ETS was positively associated with allergic sensitization in children with an adjusted odds ratio (aOR) for SPT+ of 2.32 (95% confidence interval (CI): 1.28-4.22) and the aOR for sIgE+ was 2.53 (95% CI: 1.43-4.48). Contrarily, for children with a positive maternal history, the aOR for SPT+ and sIgE+ was 0.56 (95% CI: 0.24-1.32) and 0.43 (95% CI: 0.20-0.91), respectively. Conclusions: Using propensity score methods to rigorously control for confounding factors, ETS exposure was found to reduce the risk of allergic sensitization in children with a positive maternal history. There is a strong association between early-life ETS and the development of allergic sensitization for children aged 2-3 years without maternal history. Using propensity score methods to rigorously control for confounding factors, we found that early-life exposure to household tobacco smoke reduces the risk of allergic sensitization in children with a maternal history of allergy/asthma. However, there is a strong increased risk for children aged 2-3 years without a maternal history.
KW - allergic sensitizaton
KW - birth cohort
KW - propensity score
KW - tobacco smoke
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U2 - 10.1111/j.1440-1843.2012.02201.x
DO - 10.1111/j.1440-1843.2012.02201.x
M3 - Article
C2 - 22616936
AN - SCOPUS:84866647842
SN - 1323-7799
VL - 17
SP - 1068
EP - 1072
JO - Respirology
JF - Respirology
IS - 7
ER -