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

Early growth characteristics and the risk of reduced lung function and asthma: A meta-analysis of 25,000 children
Early growth characteristics and the risk of reduced lung function and asthma: A meta-analysis of 25,000 children
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.
preterm birth, low birth weight, infant growth, asthma, lung function, children, meta-analysis
0091-6749
1-10
den Dekker, Herman T.
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Sonnenschein-van der Voort, Agnes M.M.
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de Jongste, Johan C.
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Anessi-Maesano, Isabella
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Barros, Henrique
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Craig, Leone
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van der Ent, C. Kors
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Kreiner-Møller, Eskil
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Kuehni, Claudia E.
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Mélen, Erik
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Mommers, Monique
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Morales, Eva
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Penders, John
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Pike, Katy
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Porta, Daniela
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Roberts, Graham
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Schmidt, Anne
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Schultz, Erica S.
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Schulz, Holger
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Sunyer, Jordi
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Torrent, Matias
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Vassilaki, Maria
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Wijga, Alet H.
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Zabaleta, Carlos
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Jaddoe, Vincent W.V.
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Duijts, Liesbeth
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den Dekker, Herman T.
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Sonnenschein-van der Voort, Agnes M.M.
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de Jongste, Johan C.
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Anessi-Maesano, Isabella
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Arshad, S. Hasan
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Barros, Henrique
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Bisgaard, Hans
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Phar, Sofia Correia
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Craig, Leone
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Devereux, Graham
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van der Ent, C. Kors
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Esplugues, Ana
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Fantini, Maria P.
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Flexeder, Claudia
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Frey, Urs
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Forastiere, Francesco
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Gehring, Ulrike
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Gori, Davide
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van der Gugten, Anne C.
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Henderson, A John
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Heude, Barbara
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Ibarluzea, Jesús
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Inskip, Hazel M.
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Keil, Thomas
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Kogevinas, Manolis
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Kreiner-Møller, Eskil
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Kuehni, Claudia E.
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Lau, Susanne
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Mélen, Erik
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Mommers, Monique
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Morales, Eva
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Penders, John
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Pike, Katy
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Porta, Daniela
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Reiss, Irwin K.
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Roberts, Graham
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Schmidt, Anne
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Schultz, Erica S.
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Schulz, Holger
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Sunyer, Jordi
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Torrent, Matias
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Vassilaki, Maria
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Wijga, Alet H.
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Zabaleta, Carlos
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Jaddoe, Vincent W.V.
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Duijts, Liesbeth
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den Dekker, Herman T., Sonnenschein-van der Voort, Agnes M.M., de Jongste, Johan C., Anessi-Maesano, Isabella, Arshad, S. Hasan, Barros, Henrique, Beardsmore, Caroline S., Bisgaard, Hans, Phar, Sofia Correia, Craig, Leone, Devereux, Graham, van der Ent, C. Kors, Esplugues, Ana, Fantini, Maria P., Flexeder, Claudia, Frey, Urs, Forastiere, Francesco, Gehring, Ulrike, Gori, Davide, van der Gugten, Anne C., Henderson, A John, Heude, Barbara, Ibarluzea, Jesús, Inskip, Hazel M., Keil, Thomas, Kogevinas, Manolis, Kreiner-Møller, Eskil, Kuehni, Claudia E., Lau, Susanne, Mélen, Erik, Mommers, Monique, Morales, Eva, Penders, John, Pike, Katy, Porta, Daniela, Reiss, Irwin K., Roberts, Graham, Schmidt, Anne, Schultz, Erica S., Schulz, Holger, Sunyer, Jordi, Torrent, Matias, Vassilaki, Maria, Wijga, Alet H., Zabaleta, Carlos, Jaddoe, Vincent W.V. and Duijts, Liesbeth (2015) Early growth characteristics and the risk of reduced lung function and asthma: A meta-analysis of 25,000 children. Journal of Allergy and Clinical Immunology, 1-10. (doi:10.1016/j.jaci.2015.08.050). (PMID:26548843)

Record type: 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.

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More information

Accepted/In Press date: 15 August 2015
e-pub ahead of print date: 11 November 2015
Keywords: preterm birth, low birth weight, infant growth, asthma, lung function, children, meta-analysis
Organisations: Faculty of Medicine

Identifiers

Local EPrints ID: 386975
URI: http://eprints.soton.ac.uk/id/eprint/386975
ISSN: 0091-6749
PURE UUID: aa412ec8-07b1-44a4-b854-b0464bebfb1d
ORCID for Hazel M. Inskip: ORCID iD orcid.org/0000-0001-8897-1749
ORCID for Graham Roberts: ORCID iD orcid.org/0000-0003-2252-1248

Catalogue record

Date deposited: 05 Feb 2016 15:36
Last modified: 15 Mar 2024 03:22

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Contributors

Author: Herman T. den Dekker
Author: Agnes M.M. Sonnenschein-van der Voort
Author: Johan C. de Jongste
Author: Isabella Anessi-Maesano
Author: S. Hasan Arshad
Author: Henrique Barros
Author: Caroline S. Beardsmore
Author: Hans Bisgaard
Author: Sofia Correia Phar
Author: Leone Craig
Author: Graham Devereux
Author: C. Kors van der Ent
Author: Ana Esplugues
Author: Maria P. Fantini
Author: Claudia Flexeder
Author: Urs Frey
Author: Francesco Forastiere
Author: Ulrike Gehring
Author: Davide Gori
Author: Anne C. van der Gugten
Author: A John Henderson
Author: Barbara Heude
Author: Jesús Ibarluzea
Author: Hazel M. Inskip ORCID iD
Author: Thomas Keil
Author: Manolis Kogevinas
Author: Eskil Kreiner-Møller
Author: Claudia E. Kuehni
Author: Susanne Lau
Author: Erik Mélen
Author: Monique Mommers
Author: Eva Morales
Author: John Penders
Author: Katy Pike
Author: Daniela Porta
Author: Irwin K. Reiss
Author: Graham Roberts ORCID iD
Author: Anne Schmidt
Author: Erica S. Schultz
Author: Holger Schulz
Author: Jordi Sunyer
Author: Matias Torrent
Author: Maria Vassilaki
Author: Alet H. Wijga
Author: Carlos Zabaleta
Author: Vincent W.V. Jaddoe
Author: Liesbeth Duijts

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