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Early exposure to infections increases the risk of allergic rhinitis-a systematic review and meta-analysis
JunRong Chen1, Xiaohua Liu1,2, Zixin Liu1,3
1Key Laboratory of Study and Discovery of Small Targeted Molecules of Hunan Province, School of Medicine, Hunan Normal University, Hunan, 410013, China.
Insights
Infections during pregnancy and early childhood, particularly respiratory and gastrointestinal, increase the risk of developing allergic rhinitis (AR) later in life. Prevention strategies are crucial for maternal and infant health.
Area of Science:
- Epidemiology
- Allergy and Immunology
- Public Health
Background:
- Allergic rhinitis (AR) is a prevalent condition affecting children globally.
- The role of early-life environmental exposures, specifically infections, in AR development requires further elucidation.
- Understanding the link between prenatal and early-life infections and subsequent AR risk is critical for preventative strategies.
Approach:
- A systematic literature search was conducted across multiple databases (PubMed, Embase, Web of Science, etc.) up to April 2022.
- Meta-analysis was employed to synthesize data from eligible studies assessing the association between maternal infection during pregnancy, infections in the first two years of life, and the risk of childhood AR.
- Effect values (OR, HR, RR) and 95% confidence intervals (95% CI) were extracted and analyzed.
Key Points:
- Maternal infection during pregnancy was associated with a significantly increased risk of AR in offspring (OR = 1.34, 95% CI: 1.08-1.67).
- Early-life infections within the first two years of life were also closely linked to subsequent AR (OR = 1.25, 95% CI: 1.12-1.40).
- Specific early infections, including upper respiratory tract infections (OR = 1.32, 95% CI: 1.06-1.65) and gastrointestinal infections (OR = 1.37, 95% CI: 1.01-1.86), showed a notable association with AR risk.
Conclusions:
- Evidence supports a causal link between prenatal infections and increased risk of childhood allergic rhinitis.
- Infections occurring within the first two years of life, particularly respiratory and gastrointestinal, are significant risk factors for developing AR.
- Emphasizing infection prevention during pregnancy and early childhood is essential for mitigating the burden of allergic rhinitis.
Objective:
The purpose of this study was to provide evidence for early life care by meta-analyzing the relationship between infection during pregnancy and up to 2 years of age and the risk of subsequent allergic rhinitis (AR).
Methods:
Published studies up to April 2022 were systematically searched in PubMed, Embase, Web of Science, Cochrane Library, SinoMed, CNKI, Wanfang Database, and VIP. Literature screening, including quality assessment, was performed, and the effect values (OR, HR, RR) and 95% confidence intervals (95% CI) of infection during pregnancy and up to 2 years of age and allergic rhinitis were extracted from each qualified study.
Results:
In total, 5 studies with a sample size of 82,256 reported the relationship between infection during pregnancy and offspring AR. Meta-analysis showed that maternal infection during pregnancy was associated with an increased risk of childhood AR in offspring (OR = 1.34, 95% CI: 1.08-1.67). Altogether, 13 studies with a sample size of 78,426 reported evidence of an association between infection within 2 years of age and subsequent AR in children. A pooled meta-analysis of all studies showed that early infection within 2 years of age was closely associated with childhood AR (OR = 1.25, 95% CI: 1.12-1.40), especially upper respiratory tract infection (OR = 1.32, 95% CI: 1.06-1.65) and gastrointestinal infections (OR = 1.37, 95% CI: 1.01-1.86), but ear infection showed similar results in the cohort study (OR = 1.13, 95% CI: 1.04-1.22).
Conclusion:
Current evidence suggests that infection during pregnancy, early upper respiratory infection, gastrointestinal infections and ear infection within 2 years of age would increase the risk of AR in children. Therefore, the prevention of infection during pregnancy and in infancy and young children needs to be emphasized.
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