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

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

doi: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

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

^*Corresponding author for this work

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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 language	English
Pages (from-to)	1026-1035
Number of pages	10
Journal	Journal of Allergy and Clinical Immunology
Volume	137
Issue number	4
Early online date	11 Nov 2015
DOIs	https://doi.org/10.1016/j.jaci.2015.08.050
Publication status	Published - Apr 2016

Keywords

asthma
children
infant growth
low birth weight
lung function
meta-analysis
preterm birth

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den Dekker, H. T., Sonnenschein-van der Voort, A. M. 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., ... 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, HT, Sonnenschein-van der Voort, AMM, 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-Møller, E, Kuehni, CE, Lau, S, Mélen, 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, VWV & 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

@article{2e5422d18f3c4389a9084ff4bab580f4,

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.",

keywords = "asthma, children, infant growth, low birth weight, lung function, meta-analysis, preterm birth",

author = "{den Dekker}, {Herman T.} and {Sonnenschein-van der Voort}, {Agnes M. M.} and {de Jongste}, {Johan C.} and Isabella Anessi-Maesano and Arshad, {S. Hasan} and Henrique Barros and Beardsmore, {Caroline S.} and Hans Bisgaard and Phar, {Sofia Correia} and Leone Craig and Graham Devereux and {van der Ent}, {C. Kors} and Ana Esplugues and Fantini, {Maria P.} and Claudia Flexeder and Urs Frey and Francesco Forastiere and Ulrike Gehring and Davide Gori and {van der Gugten}, {Anne C.} and Henderson, {A. John} and Barbara Heude and Jes{\'u}s Ibarluzea and Inskip, {Hazel M.} and Thomas Keil and Manolis Kogevinas and Eskil Kreiner-M{\o}ller and Kuehni, {Claudia E.} and Susanne Lau and Erik M{\'e}len and Monique Mommers and Eva Morales and John Penders and Pike, {Katy C.} and Daniela Porta and Reiss, {Irwin K.} and Graham Roberts and Anne Schmidt and Schultz, {Erica S.} and Holger Schulz and Jordi Sunyer and Matias Torrent and Maria Vassilaki and Wijga, {Alet H.} and Carlos Zabaleta and Jaddoe, {Vincent W. V.} and Liesbeth Duijts",

note = "Disclosure of potential conflict of interest: I. Anessi-Maesano has received a grant from the FP7 MeDALL project (Mechanisms of the Development of ALLergy, FP7 no. 261357) and has board memberships with the European Respiratory Journal, Clinical and Experimental Allergy, the International Journal of Tuberculosis and Lung Disease, BMC Public Health, the European Respiratory Review, Multidisciplinary Respiratory Medicine, Therapeutic Advances in Respiratory Disease, Multidisciplinary Review Frontiers in Medicine, and La lettre du pneumologue. S. H. Arshad has received grants from the National Institutes of Health (NIH) and the Medical Research Council and has consultant arrangements with Merck & Co. U. Frey and A. Schmidt have received grants from the Swiss National Science Foundation. A. J. Henderson has received grants from the Medical Research Council and the Wellcome Trust. H. M. Inskip has received grants from the UK Medical Research Council, the British Heart Foundation, Asthma Research UK, the British Lung Foundation, the Food Standards Agency, and the Dunhill Medical Trust; is deputy chair of a grant-funding board for the UK Medical Research Council; and has her employment funded by the Medical Research Council. S. Lau has received grants from the German Research Foundation, Allergopharma, and Symbiopharma and has consultant arrangements with Merck. K. C. Pike has received grants from the Food Standards Agency and the British Lung Foundation. The rest of the authors declare that they have no relevant conflicts of interest.",

year = "2016",

month = apr,

doi = "10.1016/j.jaci.2015.08.050",

language = "English",

volume = "137",

pages = "1026--1035",

journal = "Journal of Allergy and Clinical Immunology",

issn = "0091-6749",

publisher = "Mosby/Elsevier,",

number = "4",

}

TY - JOUR

T1 - Early growth characteristics and the risk of reduced lung function and asthma

T2 - A meta-analysis of 25,000 children

AU - den Dekker, Herman T.

AU - Sonnenschein-van der Voort, Agnes M. M.

AU - de Jongste, Johan C.

AU - Anessi-Maesano, Isabella

AU - Arshad, S. Hasan

AU - Barros, Henrique

AU - Beardsmore, Caroline S.

AU - Bisgaard, Hans

AU - Phar, Sofia Correia

AU - Craig, Leone

AU - Devereux, Graham

AU - van der Ent, C. Kors

AU - Esplugues, Ana

AU - Fantini, Maria P.

AU - Flexeder, Claudia

AU - Frey, Urs

AU - Forastiere, Francesco

AU - Gehring, Ulrike

AU - Gori, Davide

AU - van der Gugten, Anne C.

AU - Henderson, A. John

AU - Heude, Barbara

AU - Ibarluzea, Jesús

AU - Inskip, Hazel M.

AU - Keil, Thomas

AU - Kogevinas, Manolis

AU - Kreiner-Møller, Eskil

AU - Kuehni, Claudia E.

AU - Lau, Susanne

AU - Mélen, Erik

AU - Mommers, Monique

AU - Morales, Eva

AU - Penders, John

AU - Pike, Katy C.

AU - Porta, Daniela

AU - Reiss, Irwin K.

AU - Roberts, Graham

AU - Schmidt, Anne

AU - Schultz, Erica S.

AU - Schulz, Holger

AU - Sunyer, Jordi

AU - Torrent, Matias

AU - Vassilaki, Maria

AU - Wijga, Alet H.

AU - Zabaleta, Carlos

AU - Jaddoe, Vincent W. V.

AU - Duijts, Liesbeth

N1 - Disclosure of potential conflict of interest: I. Anessi-Maesano has received a grant from the FP7 MeDALL project (Mechanisms of the Development of ALLergy, FP7 no. 261357) and has board memberships with the European Respiratory Journal, Clinical and Experimental Allergy, the International Journal of Tuberculosis and Lung Disease, BMC Public Health, the European Respiratory Review, Multidisciplinary Respiratory Medicine, Therapeutic Advances in Respiratory Disease, Multidisciplinary Review Frontiers in Medicine, and La lettre du pneumologue. S. H. Arshad has received grants from the National Institutes of Health (NIH) and the Medical Research Council and has consultant arrangements with Merck & Co. U. Frey and A. Schmidt have received grants from the Swiss National Science Foundation. A. J. Henderson has received grants from the Medical Research Council and the Wellcome Trust. H. M. Inskip has received grants from the UK Medical Research Council, the British Heart Foundation, Asthma Research UK, the British Lung Foundation, the Food Standards Agency, and the Dunhill Medical Trust; is deputy chair of a grant-funding board for the UK Medical Research Council; and has her employment funded by the Medical Research Council. S. Lau has received grants from the German Research Foundation, Allergopharma, and Symbiopharma and has consultant arrangements with Merck. K. C. Pike has received grants from the Food Standards Agency and the British Lung Foundation. The rest of the authors declare that they have no relevant conflicts of interest.

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 - asthma

KW - children

KW - infant growth

KW - low birth weight

KW - lung function

KW - meta-analysis

KW - preterm birth

UR - http://www.scopus.com/inward/record.url?scp=84949254968&partnerID=8YFLogxK

U2 - 10.1016/j.jaci.2015.08.050

DO - 10.1016/j.jaci.2015.08.050

M3 - Article

AN - SCOPUS:84949254968

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 -

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

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Leone Craig

Graham Devereux

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

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Leone Craig

Graham Devereux

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