Early growth characteristics and the risk of reduced lung function and asthma: A meta-analysis of 25,000 children
Journal of Allergy and Clinical Immunology , Volume 137 - Issue 4 p. 1026- 1035
Background Children born preterm or with a small size for gestational age are at increased risk for childhood asthma. Objective We sought to assess the hypothesis that these associations are explained by reduced airway patency. Methods We used individual participant data of 24,938 children from 24 birth cohorts to examine and meta-analyze the associations of gestational age, size for gestational age, and infant weight gain with childhood lung function and asthma (age range, 3.9-19.1 years). Second, we explored whether these lung function outcomes mediated the associations of early growth characteristics with childhood asthma. Results Children born with a younger gestational age had a lower FEV1, FEV1/forced vital capacity (FVC) ratio, and forced expiratory volume after exhaling 75% of vital capacity (FEF75), whereas those born with a smaller size for gestational age at birth had a lower FEV1 but higher FEV1/FVC ratio (P <.05). Greater infant weight gain was associated with higher FEV1 but lower FEV1/FVC ratio and FEF75 in childhood (P <.05). All associations were present across the full range and independent of other early-life growth characteristics. Preterm birth, low birth weight, and greater infant weight gain were associated with an increased risk of childhood asthma (pooled odds ratio, 1.34 [95% CI, 1.15-1.57], 1.32 [95% CI, 1.07-1.62], and 1.27 [95% CI, 1.21-1.34], respectively). Mediation analyses suggested that FEV1, FEV1/FVC ratio, and FEF75 might explain 7% (95% CI, 2% to 10%) to 45% (95% CI, 15% to 81%) of the associations between early growth characteristics and asthma. Conclusions Younger gestational age, smaller size for gestational age, and greater infant weight gain were across the full ranges associated with childhood lung function. These associations explain the risk of childhood asthma to a substantial extent.
|asthma, children, infant growth, low birth weight, lung function, meta-analysis, Preterm birth|
|Journal of Allergy and Clinical Immunology|
|This work was funded by the European Commission 7th Framework Programme; grant id fp7/261357 - Mechanisms of the Development of ALLergy (MEDALL)|
|Organisation||Generation R Study Group|
den Dekker, H.T, van der Sonnenschein-Voort, A.M.M, de Jongste, J.C, Anessi-Maesano, I, Arshad, S.H, Barros, A.I, … Duijts, L. (2016). Early growth characteristics and the risk of reduced lung function and asthma: A meta-analysis of 25,000 children. Journal of Allergy and Clinical Immunology (Vol. 137, pp. 1026–1035). doi:10.1016/j.jaci.2015.08.050