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

H.T. den Dekker, A.M. Sonnenschein-va Voort, J.C. de Jongste, I. Anessi-Maesano, S.H. Arshad, H. Barros, C.S. Beardsmore, H. Bisgaard, S.C. Phar, L. Craig, G. Devereux, C.K. van der Ent, A. Esplugues, M.P. Fantini, C. Flexeder, U. Frey, F. Forastiere, U. Gehring, D. Gori, A.C. van der GugtenA.J. Henderson, B. Heude, J. Ibarluzea, H.M. Inskip, T. Keil, M. Kogevinas, E. Kreiner-Moller, C.E. Kuehni, S. Lau, E. Melen, M. Mommers, E. Morales, J. Penders, K.C. Pike, D. Porta, I.K. Reiss, G. Roberts, A. Schmidt, E.S. Schultz, H. Schulz, J. Sunyer, M. Torrent, M. Vassilaki, A.H. Wijga, C. Zabaleta, V.W. Jaddoe, L. Duijts

Research output: Contribution to journalArticleAcademicpeer-review

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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.
Original languageEnglish
Pages (from-to)1026-1035
Number of pages10
JournalJournal of Allergy and Clinical Immunology
Volume137
Issue number4
Early online date11 Nov 2015
DOIs
Publication statusPublished - Apr 2016

Keywords

  • Preterm birth
  • low birth weight
  • infant growth
  • asthma
  • lung function
  • children
  • meta-analysis
  • OBSTRUCTIVE PULMONARY-DISEASE
  • BIRTH-WEIGHT
  • PRETERM BIRTH
  • RESPIRATORY-FUNCTION
  • MEASUREMENT ERROR
  • AIRWAY FUNCTION
  • CHILDHOOD
  • AGE
  • ADOLESCENCE
  • SPIROMETRY

Cite this

den Dekker, H. T., Sonnenschein-va Voort, A. M., de Jongste, J. C., Anessi-Maesano, I., Arshad, S. H., Barros, H., ... Duijts, L. (2016). 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, 137(4), 1026-1035. https://doi.org/10.1016/j.jaci.2015.08.050
den Dekker, H.T. ; Sonnenschein-va Voort, A.M. ; de Jongste, J.C. ; Anessi-Maesano, I. ; Arshad, S.H. ; Barros, H. ; Beardsmore, C.S. ; Bisgaard, H. ; Phar, S.C. ; Craig, L. ; Devereux, G. ; van der Ent, C.K. ; Esplugues, A. ; Fantini, M.P. ; Flexeder, C. ; Frey, U. ; Forastiere, F. ; Gehring, U. ; Gori, D. ; van der Gugten, A.C. ; Henderson, A.J. ; Heude, B. ; Ibarluzea, J. ; Inskip, H.M. ; Keil, T. ; Kogevinas, M. ; Kreiner-Moller, E. ; Kuehni, C.E. ; Lau, S. ; Melen, E. ; Mommers, M. ; Morales, E. ; Penders, J. ; Pike, K.C. ; Porta, D. ; Reiss, I.K. ; Roberts, G. ; Schmidt, A. ; Schultz, E.S. ; Schulz, H. ; Sunyer, J. ; Torrent, M. ; Vassilaki, M. ; Wijga, A.H. ; Zabaleta, C. ; Jaddoe, V.W. ; Duijts, L. / Early growth characteristics and the risk of reduced lung function and asthma: A meta-analysis of 25,000 children. In: Journal of Allergy and Clinical Immunology. 2016 ; Vol. 137, No. 4. pp. 1026-1035.
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title = "Early growth characteristics and the risk of reduced lung function and asthma: A meta-analysis of 25,000 children",
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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author = "{den Dekker}, H.T. and {Sonnenschein-va Voort}, A.M. and {de Jongste}, J.C. and I. Anessi-Maesano and S.H. Arshad and H. Barros and C.S. Beardsmore and H. Bisgaard and S.C. Phar and L. Craig and G. Devereux and {van der Ent}, C.K. and A. Esplugues and M.P. Fantini and C. Flexeder and U. Frey and F. Forastiere and U. Gehring and D. Gori and {van der Gugten}, A.C. and A.J. Henderson and B. Heude and J. Ibarluzea and H.M. Inskip and T. Keil and M. Kogevinas and E. Kreiner-Moller and C.E. Kuehni and S. Lau and E. Melen and M. Mommers and E. Morales and J. Penders and K.C. Pike and D. Porta and I.K. Reiss and G. Roberts and A. Schmidt and E.S. Schultz and H. Schulz and J. Sunyer and M. Torrent and M. Vassilaki and A.H. Wijga and C. Zabaleta and V.W. Jaddoe and L. Duijts",
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den Dekker, HT, Sonnenschein-va Voort, AM, de Jongste, JC, Anessi-Maesano, I, Arshad, SH, Barros, H, Beardsmore, CS, Bisgaard, H, Phar, SC, Craig, L, Devereux, G, van der Ent, CK, Esplugues, A, Fantini, MP, Flexeder, C, Frey, U, Forastiere, F, Gehring, U, Gori, D, van der Gugten, AC, Henderson, AJ, Heude, B, Ibarluzea, J, Inskip, HM, Keil, T, Kogevinas, M, Kreiner-Moller, E, Kuehni, CE, Lau, S, Melen, E, Mommers, M, Morales, E, Penders, J, Pike, KC, Porta, D, Reiss, IK, Roberts, G, Schmidt, A, Schultz, ES, Schulz, H, Sunyer, J, Torrent, M, Vassilaki, M, Wijga, AH, Zabaleta, C, Jaddoe, VW & Duijts, L 2016, '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, vol. 137, no. 4, pp. 1026-1035. https://doi.org/10.1016/j.jaci.2015.08.050

Early growth characteristics and the risk of reduced lung function and asthma: A meta-analysis of 25,000 children. / den Dekker, H.T.; Sonnenschein-va Voort, A.M.; de Jongste, J.C.; Anessi-Maesano, I.; Arshad, S.H.; Barros, H.; Beardsmore, C.S.; Bisgaard, H.; Phar, S.C.; Craig, L.; Devereux, G.; van der Ent, C.K.; Esplugues, A.; Fantini, M.P.; Flexeder, C.; Frey, U.; Forastiere, F.; Gehring, U.; Gori, D.; van der Gugten, A.C.; Henderson, A.J.; Heude, B.; Ibarluzea, J.; Inskip, H.M.; Keil, T.; Kogevinas, M.; Kreiner-Moller, E.; Kuehni, C.E.; Lau, S.; Melen, E.; Mommers, M.; Morales, E.; Penders, J.; Pike, K.C.; Porta, D.; Reiss, I.K.; Roberts, G.; Schmidt, A.; Schultz, E.S.; Schulz, H.; Sunyer, J.; Torrent, M.; Vassilaki, M.; Wijga, A.H.; Zabaleta, C.; Jaddoe, V.W.; Duijts, L.

In: Journal of Allergy and Clinical Immunology, Vol. 137, No. 4, 04.2016, p. 1026-1035.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Early growth characteristics and the risk of reduced lung function and asthma: A meta-analysis of 25,000 children

AU - den Dekker, H.T.

AU - Sonnenschein-va Voort, A.M.

AU - de Jongste, J.C.

AU - Anessi-Maesano, I.

AU - Arshad, S.H.

AU - Barros, H.

AU - Beardsmore, C.S.

AU - Bisgaard, H.

AU - Phar, S.C.

AU - Craig, L.

AU - Devereux, G.

AU - van der Ent, C.K.

AU - Esplugues, A.

AU - Fantini, M.P.

AU - Flexeder, C.

AU - Frey, U.

AU - Forastiere, F.

AU - Gehring, U.

AU - Gori, D.

AU - van der Gugten, A.C.

AU - Henderson, A.J.

AU - Heude, B.

AU - Ibarluzea, J.

AU - Inskip, H.M.

AU - Keil, T.

AU - Kogevinas, M.

AU - Kreiner-Moller, E.

AU - Kuehni, C.E.

AU - Lau, S.

AU - Melen, E.

AU - Mommers, M.

AU - Morales, E.

AU - Penders, J.

AU - Pike, K.C.

AU - Porta, D.

AU - Reiss, I.K.

AU - Roberts, G.

AU - Schmidt, A.

AU - Schultz, E.S.

AU - Schulz, H.

AU - Sunyer, J.

AU - Torrent, M.

AU - Vassilaki, M.

AU - Wijga, A.H.

AU - Zabaleta, C.

AU - Jaddoe, V.W.

AU - Duijts, L.

PY - 2016/4

Y1 - 2016/4

N2 - 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.

AB - 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.

KW - Preterm birth

KW - low birth weight

KW - infant growth

KW - asthma

KW - lung function

KW - children

KW - meta-analysis

KW - OBSTRUCTIVE PULMONARY-DISEASE

KW - BIRTH-WEIGHT

KW - PRETERM BIRTH

KW - RESPIRATORY-FUNCTION

KW - MEASUREMENT ERROR

KW - AIRWAY FUNCTION

KW - CHILDHOOD

KW - AGE

KW - ADOLESCENCE

KW - SPIROMETRY

U2 - 10.1016/j.jaci.2015.08.050

DO - 10.1016/j.jaci.2015.08.050

M3 - Article

VL - 137

SP - 1026

EP - 1035

JO - Journal of Allergy and Clinical Immunology

JF - Journal of Allergy and Clinical Immunology

SN - 0091-6749

IS - 4

ER -

den Dekker HT, Sonnenschein-va Voort AM, de Jongste JC, Anessi-Maesano I, Arshad SH, Barros H et al. 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. 2016 Apr;137(4):1026-1035. https://doi.org/10.1016/j.jaci.2015.08.050