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J Allergy Clin Immunol. 2014 May;133(5):1317-29. doi: 10.1016/j.jaci.2013.12.1082. Epub 2014 Feb 12.

Preterm birth, infant weight gain, and childhood asthma risk: a meta-analysis of 147,000 European children.

Author information

1
Generation R Study Group, Erasmus Medical Center, Rotterdam, The Netherlands; Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands; Department of Paediatrics, Division of Respiratory Medicine, Erasmus Medical Center, Rotterdam, The Netherlands.
2
Department of Biostatistics, Erasmus Medical Center, Rotterdam, The Netherlands; Institute of Pedagogical Sciences, Erasmus University Rotterdam, Rotterdam, The Netherlands; Institute of Psychology, Erasmus University Rotterdam, Rotterdam, The Netherlands.
3
Department of Paediatrics, Division of Respiratory Medicine, Erasmus Medical Center, Rotterdam, The Netherlands.
4
EPAR, UMR-S 707 INSERM Paris, Paris, France; EPAR, UMR-S 707, Université Pierre et Marie Curie Paris 06, Paris, France.
5
David Hide Asthma and Allergy Research Centre, St Mary's Hospital, Newport, Isle of Wight, United Kingdom.
6
Department of Clinical Epidemiology, Predictive Medicine and Public Health, University of Porto Medical School, Porto, Portugal.
7
Public Health Division of Gipuzkoa, Gipuzkoa, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Barcelona, Spain.
8
Copenhagen Prospective Studies on Asthma in Childhood (COPSAC), Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark; Danish Pediatric Asthma Center, Copenhagen University Hospital, Gentofte, Denmark.
9
Department of Social Medicine, School of Medicine, University of Crete, Crete, Greece.
10
Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
11
Applied Health Sciences, University of Aberdeen, Aberdeen, United Kingdom.
12
Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland.
13
Institute of Experimental Medicine, Academy of Sciences of the Czech Republic, Prague, Czech Republic.
14
Division of Pediatrics, Department of Clinical and Experimental Medicine, Linköping University, and Pediatric Clinic, County Council of Östergötland County Council, Linköping, Sweden.
15
Department of Genes and Environment, Division of Epidemiology, Norwegian Institute of Public Health, Oslo, Norway.
16
Department of Paediatric Pulmonology, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, The Netherlands.
17
Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy.
18
Department of Epidemiology, Lazio Regional Health Service, Rome, Italy.
19
University Children's Hospital Basel (UKBB), University of Basel, Basel, Switzerland.
20
Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands.
21
Nofer Institute of Occupational Medicine, Department of Environmental Epidemiology, Lodz, Poland.
22
School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom.
23
INSERM, Center for Research in Epidemiology and Population Health, U1018, Lifelong Epidemiology Of Obesity, Diabetes, and Renal Disease Team, Villejuif, France; University Paris-Sud, Villejuif, France.
24
Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Barcelona, Spain; Center for Public Health Research (CSISP), University of Valencia, Valencia, Spain; Faculty of nursery and chiropody, University of Valencia, Valencia, Spain.
25
MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, United Kingdom.
26
Institute of Social Medicine, Epidemiology and Health Economics, Charité University Medical Center, Berlin, Germany; Institute for Clinical Epidemiology and Biometry, University of Würzburg, Würzburg, Germany.
27
School of Public Health, Physiotherapy and Population Science, University College Dublin, Dublin, Ireland.
28
National School of Public Health, Athens, Greece.
29
Department of Environmental Medicine, Faculty of Public Health, Slovak Medical University, Bratislava, Slovakia.
30
Section of Social Medicine, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
31
Department of Paediatric Pneumology and Immunology, Charité University Medical Centre, Berlin, Germany.
32
Department of Epidemiology, CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands.
33
Clinical and Experimental Sciences Academic Unit, Faculty of Medicine, University of Southampton, Southampton, United Kingdom.
34
Cancer Epidemiology Unit, Department of Medical Sciences, University of Turin, Turin, Italy.
35
Division of Respiratory Medicine, Department of Pediatrics, Inselspital, University of Bern, Bern, Switzerland.
36
Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Barcelona, Spain; Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain; Department of Experimental and Health Sciences, Pompeu Fabra University, Barcelona, Spain; Institut Municipal d'Investigació Mèdica (IMIM)-Hospital del Mar, Barcelona, Spain.
37
IB-SALUT, Area de Salut de Menorca, Balearic Islands, Spain.
38
Centre for Prevention and Health Services Research, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands.
39
Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Barcelona, Spain; Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain; Department of Experimental and Health Sciences, Pompeu Fabra University, Barcelona, Spain.
40
Generation R Study Group, Erasmus Medical Center, Rotterdam, The Netherlands; Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands; Department of Paediatrics, Erasmus Medical Center, Rotterdam, The Netherlands.
41
Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands; Department of Paediatrics, Division of Respiratory Medicine, Erasmus Medical Center, Rotterdam, The Netherlands; Department of Paediatrics, Division of Neonatology, Erasmus Medical Center, Rotterdam, The Netherlands. Electronic address: l.duijts@erasmusmc.nl.

Abstract

BACKGROUND:

Preterm birth, low birth weight, and infant catch-up growth seem associated with an increased risk of respiratory diseases in later life, but individual studies showed conflicting results.

OBJECTIVES:

We performed an individual participant data meta-analysis for 147,252 children of 31 birth cohort studies to determine the associations of birth and infant growth characteristics with the risks of preschool wheezing (1-4 years) and school-age asthma (5-10 years).

METHODS:

First, we performed an adjusted 1-stage random-effect meta-analysis to assess the combined associations of gestational age, birth weight, and infant weight gain with childhood asthma. Second, we performed an adjusted 2-stage random-effect meta-analysis to assess the associations of preterm birth (gestational age <37 weeks) and low birth weight (<2500 g) with childhood asthma outcomes.

RESULTS:

Younger gestational age at birth and higher infant weight gain were independently associated with higher risks of preschool wheezing and school-age asthma (P < .05). The inverse associations of birth weight with childhood asthma were explained by gestational age at birth. Compared with term-born children with normal infant weight gain, we observed the highest risks of school-age asthma in children born preterm with high infant weight gain (odds ratio [OR], 4.47; 95% CI, 2.58-7.76). Preterm birth was positively associated with an increased risk of preschool wheezing (pooled odds ratio [pOR], 1.34; 95% CI, 1.25-1.43) and school-age asthma (pOR, 1.40; 95% CI, 1.18-1.67) independent of birth weight. Weaker effect estimates were observed for the associations of low birth weight adjusted for gestational age at birth with preschool wheezing (pOR, 1.10; 95% CI, 1.00-1.21) and school-age asthma (pOR, 1.13; 95% CI, 1.01-1.27).

CONCLUSION:

Younger gestational age at birth and higher infant weight gain were associated with childhood asthma outcomes. The associations of lower birth weight with childhood asthma were largely explained by gestational age at birth.

KEYWORDS:

Gestational age; asthma; children; cohort studies; epidemiology; infant growth; low birth weight; wheezing

Comment in

PMID:
24529685
PMCID:
PMC4024198
DOI:
10.1016/j.jaci.2013.12.1082
[Indexed for MEDLINE]
Free PMC Article

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