Mode of delivery and neonatal characteristics as risk factors for childhood asthma in Qatar: a case-control study

<bold>Background:</bold> Global asthma rates are rising, posing a major public health challenge. In Qatar, it is a common chronic disease among children, with a prevalence of 34.6%. Existing global literature on childhood asthma and perinatal and neonatal risk factors may overlook Qatar's unique socio-cultural and genetic characteristics. Therefore, this research aims to highlight the significance of regional health outcome variations. <bold>Objectives:</bold> To investigate the association between childhood asthma development in Qatar and delivery mode, gestational age, and birth weight. <bold>Methods:</bold> A hospital-based case-control study in Qatar (Jan 2020 - Jul 2023) utilized secondary data from medical records. Children aged 6-14 from outpatient clinics at Hamad General Hospital were included, with 830 asthma cases and 1512 non-asthma controls. Logistic regression assessed the associations, calculating crude (OR) and adjusted odds ratios (aOR) with a 95% confidence interval (95%CI). Confounders were identified using Directed Acyclic Graphs (DAG), and multiple imputations addressed missing data. <bold>Results:</bold> Asthma prevalence was 35.4%. 673 (28.7%) children were delivered by cesarean section, 233 (9.9%) preterm and 224 (9.6%) had low birth weight. Asthma cases showed higher male prevalence (65%) and Qatari nationality (73%) compared to controls. In multivariable analysis, cesarean delivery slightly raised asthma risk (aOR=1.15, 95% CI 0.92-1.44), while preterm birth and low birth weight had minor effects (aOR=1.07, 95% CI 0.79-1.45; aOR=1.03, 95% CI 0.61-1.73). <bold>Conlcusion:</bold> The unrecognized associations challenge existing assumptions and underscores the importantace of cotext-specific research in Qatar.