Study on the Epidemiological Status and Influencing Factors of Allergic Diseases in Children Aged 0-6: A Population-Based Survey

Introduction : Childhood allergic diseases represent a significant and escalating global health burden, particularly among children aged 0–6 years. Evidence on the associations of lifestyle factors, household environment, and prenatal exposures with these conditions remains inconsistent and heterogeneous, and epidemiological data for this key age group are still limited. This study aims to develop a standardized screening questionnaire and to assess these associations. Methods : A population-based cross-sectional study was conducted in Minhang District, Shanghai, China. Eight community health service centers and fifteen kindergartens were randomly selected. A screening questionnaire developed and confirmed in a nested case-control study was used to identify childhood asthma, allergic rhinitis (AR), atopic dermatitis (AD), and food allergies (FA). Multivariable logistic regression models were employed to examine associations of neonatal factors, residential environment, and family-related factors with allergic diseases. Results : Among 3064 children aged 0–6 years, the overall prevalence of FA, asthma, AD, and AR was 14.7%, 8.4%, 18.9%, and 20.0%, respectively. Male sex, higher socioeconomic status, only-child status, history of antibiotic use and pneumonia, and family history of allergy were associated with elevated risk of allergic diseases. In contrast, sleep duration > 12 h/day and window-opening ventilation were protective factors. Age effects varied by condition: the adjusted odds ratio (AOR) for atopic dermatitis decreased with age ( AOR = 0.85, 95% CI 0.80–0.92 ), whereas that for allergic rhinitis increased ( AOR = 1.23, 95% CI 1.14–1.32 ). The Childhood Allergy and Asthma Comprehensive Screening Questionnaire (CACSQ) exhibited strong diagnostic performance, with an AUC of 0.88 ( P < 0.001 ), sensitivity of 92%, specificity of 76%, and Kappa coefficient of 0.698. Conclusion : Genetic predisposition and modifiable environmental/lifestyle factors increase the risk of allergic diseases in children aged 0–6, whereas longer sleep duration and window ventilation may mitigate the risk. These findings carry important implications for clinical practice and public health policy. The validated CACSQ offers a reliable and effective screening tool for detection and support future longitudinal studies on the atopic march and temporal risk patterns. Registry: Chinese Clinical Trial Registry, TRN: ChiCTR2500102075, Registration date: 8 May 2025.