Differential asthma risk following respiratory infection in children from three minority populations

Rationale Severe early-life respiratory illnesses, particularly those caused by respiratory syncytial virus (RSV) and human rhinovirus (HRV), are strongly associated with the development of asthma in children. Puerto Rican children in particular have a strikingly high asthma burden, but prior studies of the potential associations between early-life respiratory illnesses and asthma in Puerto Rican and other minority populations have been limited. Objectives We sought to determine whether early-life respiratory illness was associated with asthma in Puerto Rican children relative to other minority children. Methods Using a logistic regression analysis, we examined the association between early-life respiratory illnesses (report of upper respiratory infection (URI), pneumonia, bronchitis, and bronchiolitis/RSV) within the first two years of life and physician-diagnosed asthma after the age of two in a large cohort of minority children. Measurements and Main Results Early-life respiratory illnesses were associated with greater asthma risk in Puerto Ricans relative to other racial/ethnic minority populations. Specifically, in Puerto Ricans, the odds was 6.15 (95% CI: 4.21-9.05) if the child reported at least one of the following respiratory illness: URI, pneumonia, bronchitis or bronchiolitis. The odds were also higher in Puerto Ricans when considering these conditions separately. Conclusions We observe population-specific associations between early-life respiratory illnesses and asthma, which was especially significant in Puerto Ricans. Taken together with the known high burden of RSV in Puerto Rico, our results may help explain the high burden of asthma in Puerto Ricans.