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

Mebrahtu, Teumzghi F; Feltbower, Richard; Greenwood, Darren C.; Parslow, Roger C

doi:10.1136/jech-2014-204783

Cited by 52 publications

(45 citation statements)

References 81 publications

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“…Epidemiological evidence suggests opposing effects of restricted growth before birth on asthma (increased risks) and on other allergic diseases (decreased risks) [116,117,118,119,120,121,122,123,124,125] (online suppl. table 1).…”

Section: Perinatal Exposuresmentioning

confidence: 99%

In utero Programming of Allergic Susceptibility

Grieger

Clifton

Tuck

et al. 2016

Int Arch Allergy Immunol

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Background: Around 30-40% of the world's population will experience allergy, the most common and earliest-onset noncommunicable disease. With a steady rise in the incidence of allergic disease over recent decades, up to 18% of children will suffer a respiratory, food or skin allergy before their 18th birthday. There is compelling evidence that the risk of developing allergy is influenced by early life events and particularly in utero exposures. Methods: A comprehensive literature review was undertaken which outlines prenatal risk factors and potential mechanisms underlying the development of allergy in childhood. Results: Exposures including maternal cigarette smoking, preterm birth and Caesarean delivery are implicated in predisposing infants to the later development of allergy. In contrast, restricted growth in utero, a healthy maternal diet and a larger family size are protective, but the mechanisms here are unclear and require further investigation. Conclusion: To ameliorate the allergy pandemic in young children, we must define prenatal mechanisms that alter the programming of the fetal immune system and also identify specific targets for antenatal interventions.

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Section: Perinatal Exposuresmentioning

confidence: 99%

In utero Programming of Allergic Susceptibility

Grieger

Clifton

Tuck

et al. 2016

Int Arch Allergy Immunol

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“…2 While 77 allergic constitution, sensitization to allergens [3][4][5] and/or familial history of allergic disease 6 are 78 recognized risk factors for asthma, studies also suggest that maternal vitamin D status during 79 pregnancy may be associated with the risk of asthma in childhood. 7,8 To date, some birth cohort 80 studies have shown that vitamin D status may play an important role in the development of fetal 81 lungs. [9][10][11] Also, epidemiologic studies have suggested that maternal vitamin D intake 12, 13 as well 82 as vitamin D levels in blood [14][15][16] were inversely associated with respiratory tract infections and 83 other wheezing illnesses, presumably because of its multiple immune effects including induction 84 of antibacterial responses and modulation of T-lymphocytes to suppress inflammation.…”

mentioning

confidence: 99%

In utero exposure to 25-hydroxyvitamin D and risk of childhood asthma, wheeze, and respiratory tract infections: A meta-analysis of birth cohort studies

Feng

Xun

Pike³

et al. 2017

Journal of Allergy and Clinical Immunology

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“…Although effects of LBW on asthma are likely confounded by gestational age, and preterm birth is also a risk factor for asthma, the increased risk of asthma is also apparent in children born small for gestational age (SGA, birth weight <10 th percentile, OR 1.18) as well as LBW (den Dekker et al 2016). Unlike allergies, these meta-analyses suggest that high birth weight does not affect risk of asthma (Mebrahtu et al 2015).…”

Section: Evidence For Iugr As a Protective Factor From Human Cohortsmentioning

confidence: 80%

“…Using an absolute birth weight criterion of 2.5 kg to define LBW, the incidence of wheezing disorders (predominantly asthma), in childhood and adolescence was 60% higher in LBW than non-LBW in a recent meta-analysis of >1.7 million participants in 37 studies (Mebrahtu et al 2015). Consistent with this, a recent meta-analysis of data from nearly 25,000 individuals in 24 European birth cohorts identified a 32% greater risk of asthma in LBW (< 2.5 kg) individuals compared to all others (den Dekker et al 2016).…”

Section: Evidence For Iugr As a Protective Factor From Human Cohortsmentioning

confidence: 99%

Pre-birth origins of allergy and asthma

Gatford¹,

Wooldridge

Kind

et al. 2017

Journal of Reproductive Immunology

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Highlights Key points (3-5 dot points, max 85 characters including spaces)  Prenatal exposures alter later disease risk, including for allergy  Epidemiological and experimental evidence suggests IUGR protects against allergy  Elevated methyl donor abundance in late pregnancy may predispose progeny to allergy  Maternal asthma and allergy during pregnancy predispose progeny to allergy Abstract: Allergy is a chronic disease that can develop as early as infancy, suggesting that early life factors are important in its aetiology. Variable associations between size at birth, a crude marker of the fetal environment, and allergy have been reported in humans and require comprehensive review. Associations between birth weight and allergy are however confounded in humans, and we and others have therefore begun exploring the effects of early life events on allergy in experimental models. In particular, we are using ovine models to investigate whether and how a restricted environment before birth protects against allergy, whether methyl donor availability contributes to allergic protection in IUGR, and why maternal asthma during pregnancy is associated with increased risks of allergic disease in children. We found that experimental intrauterine growth restriction (IUGR) in sheep reduced cutaneous responses to antigens in progeny, despite normal or elevated IgE responses. Furthermore, maternal methyl donor supplementation in late pregnancy partially reversed effects of experimental IUGR, consistent with the proposal that epigenetic pathways underlie some but not all effects of IUGR on allergic susceptibility. Ovine experimental allergic asthma with exacerbations reduces relative fetal size in late gestation, with some changes in immune populations in fetal thymus suggestive of increased activation. Maternal allergic asthma in mice also predisposes progeny to allergy development. In conclusion, these findings in experimental models provide direct evidence that a perturbed environment before birth alters immune system development and postnatal function, and provide opportunities to investigate underlying mechanisms and develop and evaluate interventions.

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

Abstract: Abstract:BACKGROUND: Previous observational studies have claimed that birthweight and childhood

Cited by 52 publications

References 81 publications

In utero Programming of Allergic Susceptibility

In utero Programming of Allergic Susceptibility

In utero exposure to 25-hydroxyvitamin D and risk of childhood asthma, wheeze, and respiratory tract infections: A meta-analysis of birth cohort studies

Pre-birth origins of allergy and asthma

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