D2.161 - Exploring the Early-Life Interplay Between Respiratory Health and Neurodevelopmental disorders

Emerging evidence suggests an overlap between asthma and neurodevelopmental disorders (NDDs) such as attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) in childhood. However, the early-life interplay between respiratory health and neurodevelopment remains poorly understood, including whether early asthma-like symptoms increase the risk of later NDDs, or whether early neurodevelopmental deviations predispose a child to asthma development.

This prospective study use data from 593 children enrolled in the Copenhagen Prospective Studies on Asthma in Childhood 2010 (COPSAC2010) birth cohort with longitudinal daily diary-based assessments of asthma-like symptoms at age 0-3 years, repeated lung function at age 3-10 years, early-life neurodevelopment including language, cognition and behaviour at age 0-3 years and a thorough examination of neuropsychiatric diagnoses and dimensional psychopathology as part of the COPSYCH study at age 10 years.

The current study includes longitudinal analyses of the relationship between early-life asthma-like symptoms and NDD diagnoses and traits at age 10 and early-life neurodevelopment and asthma and lung function at age 10 as well as cross-sectional assessments at age 10 based on covariate adjusted logistic and linear regression models. 

Until age 10, 64 (10.8%) had an asthma diagnosis and 65 (11%) had an ADHD diagnosis. Cross-sectionally, there was no significant association between asthma ever and ADHD at age 10 years, although 16% vs. 11% had ADHD among children with vs. without asthma (OR=1.48, 95%CI: 0.84–2.54, p=0.17). Longitudinally, asthma diagnosis and exacerbations in the first 3 years of life were significantly associated with more ADHD symptoms measured by ADHD-RS at age 10, (β=1.87, 95%CI: 0.04–3.69, p=0.045) and (β=2.34, 95%CI: .13;4.55], p=0.038), respectively. Whereas there was no association between neurodevelopmental measures at age 0-3 years and asthma at age 10.

These findings indicate a potential link between respiratory health in early life and ADHD later in childhood, which may be due to shared inflammatory or environmental mechanisms. Insights from this research may inform integrated screening and early intervention strategies for children at risk of both asthma and ADHD.