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Citation
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Martinez A, Ye M, Hessler D, de la Rosa R, Benson M, Gilgoff R, Koita K, Bucci M, Harris NB, Long D, Thakur N. Acad. Pediatr. 2024; ePub(ePub): ePub. |
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Abstract
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OBJECTIVE: To examine the association between Adverse Childhood Experiences (ACEs) and related events and asthma symptom burden in children.
METHODS: This is a cross-sectional study of baseline data from 147 participants with asthma from a cohort of children enrolled in the Pediatric ACEs Screening and Resiliency Study. Participants completed the PEdiatric ACEs and Related Life Events Screener (PEARLS) tool, a 17-item questionnaire, capturing three domains of childhood adversity- child maltreatment, household challenges and social context. Asthma symptom burden was assessed using the International Study of Asthma and Allergies in Childhood (ISAAC) core questionnaire, which asks participants to identify the presence and frequency of severe wheezing that limits speech, wheezing with exercise, nocturnal wheezing and nocturnal cough in the last 12 months. Using multivariable logistical regression models, we examined the relationship between reported PEARLS and asthma symptoms.
RESULTS: Of children with asthma, 86% reported at least one adversity, with 48% reporting four or more. The odds of severe wheeze limiting speech increased by 19% with each additional reported adversity captured by the PEARLS tool (95% CI 1.01-1.41). Increasing PEARLS scores were also associated with 16% increased odds of reporting wheeze with exercise (95% CI 1.03-1.31). Wheezing with exercise was associated with the household challenges domain (OR 1.34; 95% CI 1.05-1.72), while severe wheeze limiting speech was associated with the social context domain (OR 1.75; 95%CI 1.02-3.02).
CONCLUSION: Childhood adversities are associated with increased asthma symptom burden, suggesting the tool may be helpful in identifying children at risk for poorly controlled asthma. WHAT'S NEW: As universal screening for ACEs becomes common practice in pediatric clinical settings, our study explores how providers can utilize ACE screening to identify children at higher risk of uncontrolled asthma symptoms.
Language: en |