What is the impact of birth weight corrected for gestational age on later onset asthma: a meta-analysis

Asthma is a common multifactorial disease affecting millions worldwide. The Barker hypothesis postulates an association between later onset disease risk and energy exposure in utero. Birth weight corrected for gestational age is better for measuring the infant size, which reflects energy exposure in utero. Findings on asthma and birth weight corrected for gestational age have been inconclusive. We conducted a meta-analysis to further clarify the relationship between birth weight corrected for gestational age and later onset asthma.

A systematic literature search of the PubMed, Web of Science, MEDLINE, and Scopus databases up to January 2021 was conducted. The subject terms were used as follows: "asthma", "allerg*", "respiratory", "birth weight", "gestational age", "birth outcomes", "intrauterine growth retardation", and "fetal growth restriction".

We included 12 articles with data from a total of 6,713,596 people. Compared with non-SGA infants, infants small for gestation age (SGA) were not associated with an increased risk of asthma (OR = 1.07; 95% CI 0.94-1.21). However, in the subgroup analysis, we found an increased risk of later onset asthma among SGA in studies conducted in Asia, with a large sample size, and defined asthma through medical records rather than questionnaires. Large for gestational age (LGA) was not associated with an increased risk of asthma when non-LGA or appropriated for gestational age (AGA) infants were used as the reference (OR = 1.02; 95% CI 0.90-1.16; OR = 1.01; 95% CI 0.88-1.15).

These results indicated that neither SGA nor LGA was associated with an increased risk of asthma. However, considering the limitations of the research, these results should be interpreted with caution.