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Updated: Sep 10, 2025

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Is Palivizumabe a Protective Factor for the Development of Asthma in Children? A Systematic Review With Metanalysis

Mariana Bueno Manini1, Natali Caroline da Silva1, Rafaela Agra de Castro2

  • 1Child and Adolescent Health Postgraduate Program, State University of Campinas, Campinas, São Paulo, Brazil.

Pediatric Pulmonology
|August 22, 2025
PubMed

Insights

Palivizumab prophylaxis does not prevent asthma in premature infants without heart conditions. This medication primarily reduces severe respiratory syncytial virus (RSV) infections, not the development of childhood asthma.

Area of Science:

  • Pediatric Pulmonology
  • Neonatology
  • Clinical Immunology

Background:

  • Premature infants face heightened risks for chronic respiratory issues and severe infections like RSV.
  • Palivizumab is known to mitigate RSV severity in high-risk infants, but its effect on asthma development is not well-established.

Purpose of the Study:

  • To systematically review and meta-analyze existing literature.
  • To determine if palivizumab prophylaxis protects premature infants (without congenital heart disease) from developing asthma.

Main Methods:

  • Systematic review and meta-analysis of 14 studies.
  • Inclusion of data from 1,364,238 children, with 9232 receiving palivizumab.
  • Subgroup and sensitivity analyses were performed to assess robustness and specific populations.

Main Results:

  • No significant difference in asthma development between palivizumab recipients and controls (OR 0.84, p=0.1968).
  • Subgroup analysis for atopy history also showed no significant asthma risk reduction.
  • Palivizumab-treated infants were diagnosed younger, but gestational age differences were not significant.

Conclusions:

  • Palivizumab prophylaxis does not decrease asthma risk in premature infants without congenital heart disease.
  • The established benefit of palivizumab is in preventing severe RSV infections, not in preventing asthma onset.
Abstract

Keywords:
asthmapalivizumabprematurity

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