Early growth characteristics and the risk of reduced lung function and asthma: A meta-analysis of 25,000 children

den Dekker, Herman T; Sonnenschein-van der Voort, Agnes M M; de Jongste, Johan C; Anessi-Maesano, Isabella; Arshad, S Hasan; Barros, Henrique; Beardsmore, Caroline S; Bisgaard, Hans; Phar, Sofia Correia; Craig, Leone; Devereux, Graham; van der Ent, C Kors; Esplugues, Ana; Fantini, Maria P; Flexeder, Claudia; Frey, Urs; Forastiere, Francesco; Gehring, Ulrike; Gori, Davide; van der Gugten, Anne C; ... (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, 137(4), pp. 1026-1035. Mosby 10.1016/j.jaci.2015.08.050

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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.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Gynaecology, Paediatrics and Endocrinology (DFKE) > Clinic of Paediatric Medicine
04 Faculty of Medicine > Pre-clinic Human Medicine > Institute of Social and Preventive Medicine (ISPM)
04 Faculty of Medicine > Department of Gynaecology, Paediatrics and Endocrinology (DFKE) > Clinic of Paediatric Medicine > Paediatric Pneumology

UniBE Contributor:

Kühni, Claudia

Subjects:

600 Technology > 610 Medicine & health
300 Social sciences, sociology & anthropology > 360 Social problems & social services

ISSN:

0091-6749

Publisher:

Mosby

Language:

English

Submitter:

André Schaller

Date Deposited:

11 May 2016 12:27

Last Modified:

07 Jun 2016 13:34

Publisher DOI:

10.1016/j.jaci.2015.08.050

PubMed ID:

26548843

Uncontrolled Keywords:

Preterm birth; asthma; children; infant growth; low birth weight; lung function; meta-analysis

BORIS DOI:

10.7892/boris.80046

URI:

https://boris.unibe.ch/id/eprint/80046

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