Birth weight and childhood wheezing disorders: A systematic review and meta-analysis

17Citations
Citations of this article
143Readers
Mendeley users who have this article in their library.

Abstract

BACKGROUND: Accumulating evidence implicates early life factors in<br />the aetiology of non-communicable diseases, including asthma/wheezing<br />disorders. We undertook a systematic review investigating risks of<br />asthma/wheezing disorders in children born preterm, including the<br />increasing numbers who, as a result of advances in neonatal care,<br />now survive very preterm birth. METHODS AND FINDINGS: Two reviewers<br />independently searched seven online databases for contemporaneous<br />(1 January 1995-23 September 2013) epidemiological studies investigating<br />the association between preterm birth and asthma/wheezing disorders.<br />Additional studies were identified through reference and citation<br />searches, and contacting international experts. Quality appraisal<br />was undertaken using the Effective Public Health Practice Project<br />instrument. We pooled unadjusted and adjusted effect estimates using<br />random-effects meta-analysis, investigated "dose-response" associations,<br />and undertook subgroup, sensitivity, and meta-regression analyses<br />to assess the robustness of associations. We identified 42 eligible<br />studies from six continents. Twelve were excluded for population<br />overlap, leaving 30 unique studies involving 1,543,639 children.<br />Preterm birth was associated with an increased risk of wheezing disorders<br />in unadjusted (13.7% versus 8.3%; odds ratio [OR] 1.71, 95% CI 1.57-1.87;<br />26 studies including 1,500,916 children) and adjusted analyses (OR<br />1.46, 95% CI 1.29-1.65; 17 studies including 874,710 children). The<br />risk was particularly high among children born very preterm (<32<br />wk gestation; unadjusted: OR 3.00, 95% CI 2.61-3.44; adjusted: OR<br />2.81, 95% CI 2.55-3.12). Findings were most pronounced for studies<br />with low risk of bias and were consistent across sensitivity analyses.<br />The estimated population-attributable risk of preterm birth for childhood<br />wheezing disorders was >/=3.1%. Key limitations related to the paucity<br />of data from low- and middle-income countries, and risk of residual<br />confounding. CONCLUSIONS: There is compelling evidence that preterm<br />birth-particularly very preterm birth-increases the risk of asthma.<br />Given the projected global increases in children surviving preterm<br />births, research now needs to focus on understanding underlying mechanisms,<br />and then to translate these insights into the development of preventive<br />interventions. REVIEW REGISTRATION: PROSPERO CRD42013004965.

Cite

CITATION STYLE

APA

Mebrahtu, T. F., Feltbower, R. G., Greenwood, D. C., & Parslow, R. C. (2015). Birth weight and childhood wheezing disorders: A systematic review and meta-analysis. Journal of Epidemiology and Community Health, 69(5), 500–508. https://doi.org/10.1136/jech-2014-204783

Register to see more suggestions

Mendeley helps you to discover research relevant for your work.

Already have an account?

Save time finding and organizing research with Mendeley

Sign up for free