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Relationship between birth weight or fetal growth rate and postnatal allergy: A systematic review
Amy L Wooldridge1, Mark McMillan2, Manpreet Kaur3
1Robinson Research Institute, University of Adelaide, Adelaide, Australia; Adelaide Medical School, University of Adelaide, Adelaide, Australia; School of Human Sciences, University of Western Australia, Perth, Australia.
Insights
Intrauterine growth restriction may protect against allergies in children. Higher birth weight is linked to increased risks of food allergy and allergic dermatitis, but not allergic rhinitis.
Area of Science:
- Developmental biology
- Immunology
- Pediatrics
Background:
- Early-life exposures play a crucial role in programming individual susceptibility to allergic diseases.
- Preclinical studies indicate that intrauterine growth restriction (IUGR) offers protection against later-life inflammatory responses to allergens.
Purpose of the Study:
- To investigate the association between prenatal growth and allergy susceptibility in human subjects.
- To evaluate if intrauterine growth restriction impacts the risk of developing allergic diseases.
Main Methods:
- A systematic literature search was conducted across 11 major databases, including PubMed, Web of Science, EMBASE, and ProQuest.
- Eligible studies included prospective and retrospective cohorts, cross-sectional, and case-control designs, focusing on full-term infants or adjusting for gestational age.
- Meta-analyses were performed on data from 42 eligible studies, with a specific focus on birth weight and allergy outcomes.
Main Results:
- Increased birth weight was associated with a significantly higher risk of food allergy (OR, 1.44) and allergic dermatitis (OR, 1.17) in children.
- A 1 kg increase in birth weight correlated with a 44% greater risk of food allergy and a 17% greater risk of allergic dermatitis.
- No significant association was found between birth weight and the risk of allergic rhinitis.
Conclusions:
- Intrauterine growth restriction appears to protect against allergic diseases in humans, aligning with preclinical findings.
- The protective effects may vary depending on the specific allergic disease.
- Further research is needed to determine if these effects persist into older age and differ between severe and mild allergic disease phenotypes.
Background:
Individual susceptibility to allergic diseases is developmentally programmed by early-life exposures. Evidence from preclinical studies suggests that intrauterine growth restriction is protective against later inflammatory responses to allergens.
Objective:
We sought to evaluate whether prenatal growth affects susceptibility to allergy in human subjects.
Methods:
We systematically searched for relevant studies in 11 databases, including Web of Science, ProQuest, EMBASE, and PubMed. We included only studies that corrected for gestational age or were restricted to full-term infants to separate effects of fetal growth from those of prematurity.
Results:
The 42 eligible studies included prospective and retrospective cohort, cross-sectional, and case-control studies. Only 2 studies reported allergic asthma. A birth weight increase of 1 kg was associated with a 44% greater risk of food allergy in children (odds ratio [OR], 1.44; 95% CI, 1.04-1.99; P = .001), a 17% greater risk of ever allergic dermatitis in children (OR, 1.17; 95% CI, 1.04-1.32; P = .008), and a 34% greater risk of ever or current allergic dermatitis in infants up to 2 years of age (OR, 1.34; 95% CI, 1.08-1.68; P = .009). Risks of allergic rhinitis were not associated with birth weight.
Conclusions:
The results of these meta-analyses suggest that intrauterine growth restriction protects against allergic diseases in human subjects consistent with preclinical evidence but that effects might differ between allergic diseases. The strongest evidence is available for infancy and early childhood, and additional studies in older children and adults are needed to determine whether the effects of prenatal growth on each allergic disease persist or differ between those with severe and mild phenotypes.
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