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Objectives: We aimed to determine whether maternal mental health service use during pregnancy, a potential proxy measure of prenatal maternal stress, is associated with the development of asthma in a large population-based sample of children. We hypothesized that children born to mothers with mental health service use during pregnancy would have a higher incidence of childhood asthma. Study Design: Health administrative data from Ontario, Canada (population >13 million) was used to identify pairs of mothers linked with their children born between April 1, 2001 to March 31, 2002. Descriptive statistics were used to compare the cumulative incidence of asthma by age 12 years in children whose mothers did or did not have prenatal mental health service use. Multivariable logistic regression was used to estimate the association between prenatal maternal mental health service use and childhood asthma incidence, after adjusting for the child's sex, residency (rural vs. urban), socioeconomic status, comorbid health conditions, low birthweight, and maternal history of asthma. Results: In a population-based sample of 122,333 children, those born to mothers with mental health service use during pregnancy had increased odds of developing asthma (odds ratio: 1.16, 95% confidence intervals: 1.12, 1.20, p < 0.001). Conclusions: Prenatal maternal mental health service use is an independent risk factor for the development of asthma in childhood. This supports growing evidence for the importance of in utero exposure to maternal stress factors in asthma pathogenesis. This study highlights a potential strategy for the primary prevention of childhood asthma, namely improved recognition and management of mental health issues and stress in pregnant mothers. [ABSTRACT FROM AUTHOR]

Using Ontario healthcare administrative databases, over 228,000 children aged 0 to 9 years were identified as having asthma between 1994 and 1998 and followed until they turned 10 years old or the end of the study. The prevalence of childhood asthma increased by 35% during the study period. These children had a higher healthcare utilization and cost over $100 more per child per year than the general population, and contributed to over one third of the total Ontario Health Insurance Plan expenditures. Findings of this study revealed an enormous burden of illness to children with asthma and the healthcare system. [ABSTRACT FROM AUTHOR]

Many African-American children with asthma are inadequately treated with controller pharmacotherapy. We analyzed 2002 West Virginia Medicaid claims for 300 African-American children to determine demographic and health services use factors that predict inhaled corticosteroid (ICS) use. Approximately 38% of the children had a prescription claim for an ICS. Logistic regression showed a direct relationship between the number of claims for short-acting beta-agonists and oral corticosteroids and the likelihood of a child having a claim for an ICS. Children who used a controller agent other than an ICS also were more likely to have filled a prescription for an ICS. We conclude that children in our sample whose prescription use indicated more severe asthma were more likely to have used an ICS. Barriers to adequate pharmacotherapy for African-American children with asthma should be considered during the process of care. [ABSTRACT FROM AUTHOR]