The effect of low-cost modification of the home environment on the development of respiratory symptoms in the first year of life

Background: Previous studies have suggested that environmental exposures may be related to the development of respiratory symptoms in early life. Intervention studies, however, have not produced consistent findings. Objective: The Peer Education in Pregnancy Study examined the effect of home environment intervention with pregnant women at risk for having children with asthma on the development of respiratory symptoms in their infants. Methods: A total of 383 pregnant women whose unborn child had a first-degree relative with an allergic history were randomized to 1 of 2 intervention groups, both of whom received general health education, smoking cessation advice, and encouragement to breastfeed. In addition, the intensive education group received 3 home visits focused on home environment modification. Home assessment was performed at baseline and after 1 year of follow-up. Respiratory symptoms were identified during the first year of life. Results: Families in both intervention groups showed significant changes in several environmental factors, with significant differences between the 2 groups in insects other than cockroaches, use of mattress covers, and washing in hot water. Children in the intensive education group had slightly lower incidence rates of respiratory symptoms, but few differences were statistically significant. Conclusions: The results of this study do not provide strong support for a primary intervention focused on general modification of the home environment during pregnancy for high-risk children. It does not address the effects of more aggressive approaches or of interventions targeting individual environmental factors.