Adverse perinatal outcomes and housing conditions as determinants of early-life respiratory health: Evidence from Ireland

Background Early-life disadvantage contributes to the accumulation of health risks across the life course. Adverse perinatal outcomes—prematurity, low birth weight (LBW), and neonatal intensive care unit (NICU) admission—combined with poor housing conditions may heighten the risk of asthma and wheezing in childhood. However, their independent and interactive effects remain underexplored within a cumulative disadvantage framework. Methods Data from the nationally representative Growing Up in Ireland Cohort’08 were analysed, following children at 9 months, 3 years, and 9 years. Logistic regression models, including interaction terms to test moderating effects, were fitted to assess associations between adverse perinatal outcomes, housing conditions, and asthma and wheezing. Analyses were adjusted for sociodemographic characteristics and birth outcomes. Results Prematurity, LBW, and NICU admission were associated with higher odds of asthma and wheezing in childhood; the effects persisted for prematurity and NICU admission but weakened for LBW by age 9. Poor housing increased respiratory risk at 9 months and 3 years only. Interactions showed that prematurity and LBW combined with inadequate household warmth markedly increased asthma risk. Male sex and maternal chronic illness were consistent predictors, while maternal university education was protective. Conclusion Adverse perinatal outcomes and poor housing conditions independently and interactively increase early respiratory risks. Improving housing conditions may help reduce long-term health inequalities, especially among socioeconomically disadvantaged or medically vulnerable children.