title: Association between adverse childhood experiences in the home and pediatric asthma.
abstract: BACKGROUND
  Numerous studies suggest that psychosocial factors could contribute to pediatric asthma.
  
  
  OBJECTIVE
  To examine the relation between single and cumulative adverse childhood experiences (ACEs), a measurement of household dysfunction, on parent report of lifetime asthma in children.
  
  
  METHODS
  This cross-sectional study used data from the 2011 to 2012 National Survey of Children's Health, a nationally representative sample of children 0 to 17 years old (n = 92,472). The main exposure was parent or guardian report of 6 ACE exposures (eg, witnessing domestic violence). The relation between ACE exposures and parent-reported diagnosis of childhood asthma was examined using multivariable logistic regression after controlling for demographic, socioeconomic, and behavioral covariates.
  
  
  RESULTS
  Overall asthma prevalence was 14.6%. Exposure prevalence to any ACE was 29.2%. Increased number of ACE exposures was associated with increased odds of asthma. In the adjusted model, the odds of reporting asthma were 1.28 (95% confidence interval [CI] 1.14-1.43) for those reporting 1 ACE, 1.73 (95% CI 1.27-2.36) for those with 4 ACEs, and 1.61 (95% CI 1.15-2.26) for those with 5 or 6 ACEs compared with those with no ACE exposures. Effects were moderated by Hispanic ethnicity. Hispanic children exposed to 4 ACEs had a 4.46 times increase in lifetime asthma (95% CI 2.46-8.08); white children had a 1.19 times increase (95% CI 0.80-1.79) compared with those exposed to 0 ACE.
  
  
  CONCLUSIONS
  This study supports the growing evidence for the biopsychosocial model of asthma onset. Future studies should examine the association between ACEs and specific asthma-related health outcomes.
authors.affiliation: Departments of Emergency Medicine and Pediatrics, Section of Pediatric Emergency Medicine, Brown University/Hasbro Children's Hospital, Providence, Rhode Island; Warren Alpert Medical School of Brown University/Hasbro Children's Hospital, Providence, Rhode Island; School of Public Health, Brown University, Providence, Rhode Island. Electronic address: robyn_wing@brown.edu.
authors.forename: Robyn
authors.initials: R
authors.lastname: Wing
authors.affiliation: School of Public Health, Brown University, Providence, Rhode Island.
authors.forename: Annie
authors.initials: A
authors.lastname: Gjelsvik
authors.affiliation: Departments of Emergency Medicine and Pediatrics, Section of Pediatric Emergency Medicine, Brown University/Hasbro Children's Hospital, Providence, Rhode Island; Warren Alpert Medical School of Brown University/Hasbro Children's Hospital, Providence, Rhode Island.
authors.forename: Mariann
authors.initials: M
authors.lastname: Nocera
authors.affiliation: Warren Alpert Medical School of Brown University/Hasbro Children's Hospital, Providence, Rhode Island; Bradley/Hasbro Children's Research Center and Department of Psychiatry, Rhode Island Hospital, Providence, Rhode Island.
authors.forename: Elizabeth L
authors.initials: EL
authors.lastname: McQuaid
mesh_terms: D000293:Adolescent; D001249:Asthma / Q000453:epidemiology* / Q000523:psychology*; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D006699:Home Care Services; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D015995:Prevalence; D011584:Psychology; D013315:Stress, Psychological / Q000150:complications*