Abuse during childhood and adolescence and risk of adult-onset asthma in African American women

Background: Experiences of violence contribute to the occurrence of childhood asthma, but there is little information on the effect of early-life abuse on adult-onset asthma. Objective: We prospectively assessed the relation between physical and sexual abuse during childhood and adolescence and the incidence of adult-onset asthma in the Black Women's Health Study. Methods: We followed 28,456 women from 1995 through 2011 with biennial mailed questionnaires. Experiences of physical and sexual abuse that occurred during childhood and adolescence were obtained in 2005. Cox regression models were used to estimate incidence rate ratios (IRRs) and 95% CIs. Results: During 417,931 person-years of follow-up, 1,160 participants reported physician-diagnosed asthma and concurrent use of asthma medication. Compared with women who experienced no abuse during childhood or adolescence, the multivariable IRR for any childhood abuse was 1.24 (95% CI, 1.06-1.45), and for any adolescent abuse, it was 1.10 (95% CI, 0.88-1.36). The IRR was higher for childhood physical abuse (IRR, 1.29; 95% CI, 1.07-1.49) than for childhood sexual abuse (IRR, 1.15; 95% CI, 0.88-1.49). IRRs for physical and sexual abuse during adolescence were compatible with 1.0. The association between childhood abuse and asthma incidence was stronger in older compared with younger women. Conclusion: In this large cohort of African American women, there was a positive association between adult-onset asthma and childhood physical abuse and weaker associations for childhood sexual abuse and any abuse during adolescence. Given the high prevalence of asthma and childhood abuse, this association is of public health importance. (J Allergy Clin Immunol 2013; 131:1058-63.)