Identifying preventable risk factors for hospitalised asthma in young Aboriginal children: A whole-population cohort study

Document Type

Journal Article

Publication Title



BMJ Publishing Group


Kurongkurl Katitjin




National Health and Medical Research Council of Australia

Grant Number

NHMRC Number : 1078214, 1135273

Grant Link

http://purl.org/au-research/grants/nhmrc/1078214 http://purl.org/au-research/grants/nhmrc/1135273


Brew, B., Gibberd, A., Marks, G. B., Strobel, N., Allen, C. W., Jorm, L., ... McNamara, B. (2021). Identifying preventable risk factors for hospitalised asthma in young Aboriginal children: A whole-population cohort study. Thorax, 76, 539-546. https://doi.org/10.1136/thoraxjnl-2020-216189


© 2021 Author(s) (or their employer(s)). No commercial re-use. See rights and permissions. Published by BMJ. Background: Australia has one of the highest rates of asthma worldwide. Indigenous children have a particularly high burden of risk determinants for asthma, yet little is known about the asthma risk profile in this population. Aim: To identify and quantify potentially preventable risk factors for hospitalised asthma in Australian Aboriginal children (1-4 years of age). Methods: Birth, hospital and emergency data for all Aboriginal children born 2003-2012 in Western Australia were linked (n=32 333). Asthma was identified from hospitalisation codes. ORs and population attributable fractions were calculated for maternal age at birth, remoteness, area-level disadvantage, prematurity, low birth weight, maternal smoking in pregnancy, mode of delivery, maternal trauma and hospitalisations for acute respiratory tract infection (ARTI) in the first year of life. Results: There were 705 (2.7%) children hospitalised at least once for asthma. Risk factors associated with asthma included: being hospitalised for an ARTI (OR 4.06, 95% CI 3.44 to 4.78), area-level disadvantage (OR 1.58, 95% CI 1.28 to 1.94), being born at < 33 weeks' gestation (OR 3.30, 95% CI 2.52 to 4.32) or birth weight < 1500 g (OR 2.35, 95% CI 1.39 to 3.99). The proportion of asthma attributable to an ARTI was 31%, area-level disadvantage 18%, maternal smoking 5%, and low gestational age and birth weight were 3%-7%. We did not observe a higher risk of asthma in those children who were from remote areas. Conclusion: Improving care for pregnant Aboriginal women as well as for Aboriginal infants with ARTI may help reduce the burden of asthma in the Indigenous population.



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Prevention, detection and management of cancer and other chronic diseases