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J Allergy Clin Immunol. 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.

Author information

1
Department of Pediatrics, Division of Respiratory Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands; Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands; Generation R Study Group, Erasmus University Medical Center, Rotterdam, The Netherlands.
2
Department of Pediatrics, Division of Respiratory Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands.
3
EPAR, UMR-S 707 INSERM Paris, France; EPAR, UMR-S 707, Université Pierre et Marie Curie Paris, France.
4
David Hide Asthma and Allergy Research Centre, St Mary's Hospital, Newport, Isle of Wight, United Kingdom; Faculty of Medicine, University of Southampton, Southampton, United Kingdom; NIHR Respiratory Biomedical Research Unit, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom.
5
Department of Clinical Epidemiology, Predictive Medicine and Public Health, University of Porto Medical School, Porto, Portugal.
6
Division of Child Health, Department of Infection, Immunity & Inflammation, University of Leicester and Institute for Lung Health, Leicester, United Kingdom.
7
Copenhagen Prospective Studies on Asthma in Childhood (COPSAC2000), Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark; Danish Pediatric Asthma Center, Copenhagen University Hospital, Gentofte, Denmark.
8
Public Health Nutrition Research Group, University of Aberdeen, Aberdeen, United Kingdom; Applied Health Sciences, University of Aberdeen, Aberdeen, United Kingdom.
9
Applied Health Sciences, University of Aberdeen, Aberdeen, United Kingdom.
10
Department of Pediatric Pulmonology, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, The Netherlands.
11
Faculty of Nursing and Chiropody, Valencia, Spain; FISABIO, Valencia, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.
12
Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy.
13
Helmholtz Zentrum München, Institute of Epidemiology I, Neuherberg, Germany.
14
University Children's Hospital Basel (UKBB), University of Basel, Basel, Switzerland.
15
Department of Epidemiology, Lazio Regional Health Service, Rome, Italy.
16
Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands.
17
School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom.
18
CESP Inserm, UMRS 1018, Team 10, Villejuif, France; Université Paris-Sud, UMRS 1018 Team 10, Villejuif, France.
19
CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Public Health Division of Gipuzkoa, San Sebastian, Spain.
20
MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, United Kingdom.
21
Institute of Social Medicine, Epidemiology and Health Economics, Charité University Medical Center, Berlin, Germany; Institute for Clinical Epidemiology and Biometry, University of Würzburg, Wurzburg, Germany.
22
CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; National School of Public Health, Athens, Greece; Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain; Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain.
23
Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland.
24
Department of Pediatric Pneumology and Immunology, Charité University Medical Centre, Berlin, Germany.
25
Institute of Environmental Medicine, Karolinska Institutet, Stockholm, and Sach's Children Hospital, Stockholm, Switzerland.
26
Department of Epidemiology, CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands.
27
CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain; Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain.
28
Faculty of Medicine, University of Southampton, Southampton, United Kingdom.
29
Department of Pediatrics, Division of Neonatology, Erasmus University Medical Center, Rotterdam, The Netherlands.
30
University Children's Hospital Basel (UKBB), University of Basel, Basel, Switzerland; Division of Respiratory Medicine, Department of Pediatrics, Inselspital, University of Bern, Bern, Switzerland.
31
IB-SALUT, Area de Salut de Menorca, Balearic Islands, Spain.
32
Department of Social Medicine, School of Medicine, University of Crete, Crete, Greece.
33
Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands.
34
Nuestra Señora de la Antigua Hospital, OSAKIDETZA Basque Health Service, San Sebastian, Spain.
35
Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands; Generation R Study Group, Erasmus University Medical Center, Rotterdam, The Netherlands; Department of Pediatrics, Erasmus University Medical Center, Rotterdam, The Netherlands.
36
Department of Pediatrics, Division of Respiratory Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands; Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands; Department of Pediatrics, Division of Neonatology, Erasmus University Medical Center, Rotterdam, The Netherlands. Electronic address: l.duijts@erasmusmc.nl.

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

PMID:
26548843
DOI:
10.1016/j.jaci.2015.08.050
[Indexed for MEDLINE]

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