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The Journal of Allergy and Clinical Immunology
J Allergy Clin Immunol. May 2014; 133(5): 1317–1329.
PMCID: PMC4024198
Preterm birth, infant weight gain, and childhood asthma risk: A meta-analysis of 147,000 European children
Agnes M.M. Sonnenschein-van der Voort, PhD,a,b,c Lidia R. Arends, PhD,d,e,f Johan C. de Jongste, MD, PhD,c Isabella Annesi-Maesano, MD, PhD,g,h S. Hasan Arshad, DM,i Henrique Barros, MD, PhD,j Mikel Basterrechea, MD,k,l Hans Bisgaard, MD, DMSci,m,n Leda Chatzi, MD, PhD,o Eva Corpeleijn, PhD,p Sofia Correia, PharmD, MSc,j Leone C. Craig, MD, PhD,q Graham Devereux, MD, PhD,q Cristian Dogaru, MD, PhD,r Miroslav Dostal, MD, DSc,s Karel Duchen, MD,tMerete Eggesbø, MD, PhD,u C. Kors van der Ent, MD, PhD,v Maria P. Fantini, MD,w Francesco Forastiere, MD, PhD,xUrs Frey, MD, PhD,y Ulrike Gehring, PhD,z Davide Gori, MD,w Anne C. van der Gugten, MD, PhD,v Wojciech Hanke, MD, PhD,aa A. John Henderson, MD, PhD,bb Barbara Heude, PhD,cc,dd Carmen Iñiguez, PhD,l,ee,ff Hazel M. Inskip, MSc, PhD,gg Thomas Keil, MD, MScPH,hh,ii Cecily C. Kelleher, MD, MPH,jj Manolis Kogevinas, MD, PhD,kk Eskil Kreiner-Møller, MD,m,n Claudia E. Kuehni, MD, PhD,r Leanne K. Küpers, MSc,p Kinga Lancz, PhD,ll Pernille S. Larsen, MSc,mm Susanne Lau, MD, PhD,nn Johnny Ludvigsson, MD, PhD,t Monique Mommers, PhD,oo Anne-Marie Nybo Andersen, MD, PhD,mm Lubica Palkovicova, MD, PhD,ll Katharine C. Pike, MD, PhD,pp Costanza Pizzi, MSc,qq Kinga Polanska, PhD,aa Daniela Porta, MSc,x Lorenzo Richiardi, MD, PhD,qq Graham Roberts, DM,i Anne Schmidt, MD,rrRadim J. Sram, MD, DSc,s Jordi Sunyer, MD, PhD,l,ss,tt,uu Carel Thijs, MD, PhD,oo Maties Torrent, MD, PhD,vv Karien Viljoen, MBChB, MSc,jj Alet H. Wijga, PhD,ww Martine Vrijheid, PhD,l,ss,tt Vincent W.V. Jaddoe, MD, PhD,a,b,xx andLiesbeth Duijts, MD, PhDb,c,yy,
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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 and="" asthma="" birth="" childhood="" g="" low="" outcomes.="" p="" weeks="" weight="" with="">
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.
Key words: Gestational age, low birth weight, infant growth, wheezing, asthma, children, cohort studies, epidemiology
Abbreviations used: BMI, Body mass index; ISAAC, International Study on Asthma and Allergy in Childhood; OR, Odds ratio; pOR, Pooled odds ratio; SDS, Standard deviation scores
Formats:
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 and="" asthma="" birth="" childhood="" g="" low="" outcomes.="" p="" weeks="" weight="" with="">
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.
Key words: Gestational age, low birth weight, infant growth, wheezing, asthma, children, cohort studies, epidemiology
Abbreviations used:
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