Perinatal Risk Factors for Asthma and Allergic Rhinitis in Children and Adolescents
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Objectives. In this study, we evaluated the associations between birth-related exposures, postnatal factors, and the risk ofallergic rhinitis and asthma in children and adolescents. Methods. We performed a comprehensive search of five literature databases up to May 2023. To quantify the associationsof birth-related exposures (birth weight, delivery mode, prematurity, sex, maternal age, and parental allergy history)and postnatal factors (birth order, number of siblings, breastfeeding exclusivity, and breastfeeding duration) with al-lergic disease, we calculated pooled odds ratios and 95% confidence intervals. We conducted subgroup analyses forallergic disease type, birth order, number of siblings, and parental allergy history. The methodological quality of theidentified studies was evaluated using the Newcastle-Ottawa Scale. Results. This meta-analysis included 31 studies, encompassing 218,899 patients in total. The birth-related exposures of lowbirth weight, maternal age, and prematurity (less than 37 weeks gestation) were not significantly associated with therisk of asthma or allergic rhinitis during childhood or adolescence. Male sex, family history of allergy, and cesareandelivery were linked to an elevated risk of asthma or allergic rhinitis. Among postnatal factors, exclusive breastfeed-ing, breastfeeding for longer than 6 months, second or later birth order, and having siblings exhibited protective ef-fects against allergic diseases in offspring. Conclusion. The risks of allergic rhinitis and asthma were elevated in male patients, those delivered by cesarean section,and those with a family history of allergy. Conversely, exclusive breastfeeding, breastfeeding for longer than 6 months,and having siblings corresponded to a reduced risk of respiratory allergic diseases.
Abstract
Objectives. In this study, we evaluated the associations between birth-related exposures, postnatal factors, and the risk ofallergic rhinitis and asthma in children and adolescents. Methods. We performed a comprehensive search of five literature databases up to May 2023. To quantify the associationsof birth-related exposures (birth weight, delivery mode, prematurity, sex, maternal age, and parental allergy history)and postnatal factors (birth order, number of siblings, breastfeeding exclusivity, and breastfeeding duration) with al-lergic disease, we calculated pooled odds ratios and 95% confidence intervals. We conducted subgroup analyses forallergic disease type, birth order, number of siblings, and parental allergy history. The methodological quality of theidentified studies was evaluated using the Newcastle-Ottawa Scale. Results. This meta-analysis included 31 studies, encompassing 218,899 patients in total. The birth-related exposures of lowbirth weight, maternal age, and prematurity (less than 37 weeks gestation) were not significantly associated with therisk of asthma or allergic rhinitis during childhood or adolescence. Male sex, family history of allergy, and cesareandelivery were linked to an elevated risk of asthma or allergic rhinitis. Among postnatal factors, exclusive breastfeed-ing, breastfeeding for longer than 6 months, second or later birth order, and having siblings exhibited protective ef-fects against allergic diseases in offspring. Conclusion. The risks of allergic rhinitis and asthma were elevated in male patients, those delivered by cesarean section,and those with a family history of allergy. Conversely, exclusive breastfeeding, breastfeeding for longer than 6 months,and having siblings corresponded to a reduced risk of respiratory allergic diseases.
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