Clustering of asthma and related comorbidities and their association with maternal health during pregnancy: evidence from an Australian birth cohort

Background: The population-based classification of asthma severity is varied and needs further classification. This study identified clusters of asthma and related comorbidities of Australian children aged 12-13 years; determined health outcome differences among clusters; and investigated the associations between maternal asthma and other health conditions during pregnancy and the children's clustered groups. Methods: Participants were 1777 children in the birth cohort of the Longitudinal Study of Australian Children (LSAC) who participated in the Health CheckPoint survey and the LSAC 7th Wave. A latent class analysis (LCA) was conducted to identify clusters of children afflicted with eight diseases, such as asthma (ever diagnosed or current), wheezing, eczema, sleep problem/snoring/breathing problem, general health status, having any health condition and food allergy. Multinomial logistic regression was used to investigate the association between maternal asthma or other health conditions and LCA clusters. Results: The study identified four clusters: (i) had asthma - currently healthy (11.0%), (ii) never asthmatic & healthy (64.9%), (iii) early-onset asthmatic or allergic (10.7%), and (iv) asthmatic unhealthy (13.4%). The asthmatic unhealthy cluster was in poor health in terms of health-related quality of life, general wellbeing and lung functions compared to other clusters. Children whose mothers had asthma during pregnancy were 3.31 times (OR 3.31, 95% CI: 2.06-5.30) more likely to be in the asthmatic unhealthy cluster than children whose mothers were non-asthmatic during pregnancy. Conclusion: Using LCA analysis, this study improved a classification strategy for children with asthma and related morbidities to identify the most vulnerable groups within a population-based sample.