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Meta-Analysis
. 2016 Apr;137(4):1026-1035.
doi: 10.1016/j.jaci.2015.08.050. Epub 2015 Nov 11.

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

Herman T den Dekker  1 , Agnes M M Sonnenschein-van der Voort  1 , Johan C de Jongste  2 , Isabella Anessi-Maesano  3 , S Hasan Arshad  4 , Henrique Barros  5 , Caroline S Beardsmore  6 , Hans Bisgaard  7 , Sofia Correia Phar  5 , Leone Craig  8 , Graham Devereux  9 , C Kors van der Ent  10 , Ana Esplugues  11 , Maria P Fantini  12 , Claudia Flexeder  13 , Urs Frey  14 , Francesco Forastiere  15 , Ulrike Gehring  16 , Davide Gori  12 , Anne C van der Gugten  10 , A John Henderson  17 , Barbara Heude  18 , Jesús Ibarluzea  19 , Hazel M Inskip  20 , Thomas Keil  21 , Manolis Kogevinas  22 , Eskil Kreiner-Møller  7 , Claudia E Kuehni  23 , Susanne Lau  24 , Erik Mélen  25 , Monique Mommers  26 , Eva Morales  27 , John Penders  26 , Katy C Pike  28 , Daniela Porta  15 , Irwin K Reiss  29 , Graham Roberts  4 , Anne Schmidt  30 , Erica S Schultz  25 , Holger Schulz  13 , Jordi Sunyer  27 , Matias Torrent  31 , Maria Vassilaki  32 , Alet H Wijga  33 , Carlos Zabaleta  34 , Vincent W V Jaddoe  35 , Liesbeth Duijts  36
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Free article
Meta-Analysis

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

Herman T den Dekker et al. J Allergy Clin Immunol. 2016 Apr.
Free article

Abstract

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.

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

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