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Gestational age and the risk of allergic diseases: a systematic review and meta-analysis
Xuanli Zhao1, Ke Liu1, Jiaxin Chen1
1School of Public Health, Zhejiang Chinese Medical University, Hangzhou, China.
Insights
Early and full preterm births reduce the risk of atopic dermatitis (AD). Post-term birth increases AD risk, while early preterm birth may lower allergic rhinitis (AR) risk. Gestational age impacts allergy development.
Area of Science:
- Perinatal medicine
- Allergology
- Epidemiology
Background:
- The perinatal period is a critical window for preventing atopic disorders.
- Gestational age is increasingly recognized as a factor influencing allergic disease development.
Purpose of the Study:
- To investigate the association between gestational age and the risk of atopic dermatitis (AD) and allergic rhinitis (AR).
- To provide evidence for allergy risk stratification and prevention strategies.
Main Methods:
- A meta-analysis of observational studies was conducted, searching PubMed, Embase, and Web of Science until December 31, 2023.
- Included 30 studies with over 5.4 million participants.
- Subgroup and sensitivity analyses were performed to ensure robustness.
Main Results:
- Early preterm birth (OR: 0.75) and preterm birth (OR: 0.86) were associated with reduced AD risk.
- Post-term birth was linked to an increased AD risk (OR: 1.08).
- Early preterm birth showed a suggestive association with reduced allergic rhinitis risk (OR: 0.84).
Conclusions:
- Early and full preterm births are associated with a significantly lower risk of atopic dermatitis.
- Post-term birth is linked to a higher risk of atopic dermatitis.
- Gestational age plays a nuanced role in allergic disease development, emphasizing the perinatal period for prevention.
Background:
The perinatal period has been postulated to be a window of opportunities in preventing atopic disorders. Accumulating studies suggested that an association exists between gestational age (GA) and allergic diseases.
Methods:
The meta-analysis of observational studies was conducted through a search of relevant literature until 31 December 2023 from PubMed, Embase, and Web of Science databases. Subgroup analyses and sensitivity analyses were performed to test the robustness and consistency of the observed associations.
Results:
Thirty observational studies comprising 5,410,969 participants were included in the meta-analysis. The pooled estimates (odds ratio [OR]) of atopic dermatitis (AD) risk for early preterm, preterm and post-term birth were 0.75 (95% confidence interval [CI]: 0.68-0.82), 0.86 (95% CI: 0.81-0.93), 1.08 (95% CI: 1.03-1.14), respectively. Additionally, early preterm birth was suggestively associated with reduced risk of allergic rhinitis (AR) (OR: 0.84, 95% CI: 0.73-0.97).
Conclusion:
Our study demonstrated that early preterm and preterm births were associated with a reduced risk of AD, while post-term birth was linked to an increased risk, with early preterm birth also suggestively associated with a reduced risk of AR.
Impact:
This large-scale meta-analysis demonstrates that early preterm and preterm births are associated with a significantly reduced risk of atopic dermatitis (AD), while post-term birth is linked to an increased risk. Early preterm birth is also suggestively associated with a lower risk of allergic rhinitis (AR), highlighting the nuanced role of gestational age in the development of allergic diseases. These findings underscore the importance of the perinatal period as a critical window for allergy risk stratification and early prevention strategies in pediatric populations.
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