The association between early-life respiratory infections and childhood asthma: a meta-analytic perspective

Rong Zhao1

  • 1Traditional Chinese Medicine Pediatrics, The Central Hospital of Enshi Tujia and Miao Autonomous Prefecture, Enshi, Hubei, China.

Frontiers in Medicine
|March 4, 2026
PubMed

Insights

Early-life viral infections and allergen exposures significantly increase the risk of childhood asthma and wheeze. While nutritional and probiotic interventions showed limited benefits, maternal influenza vaccination combined with viral prophylaxis offers protection against respiratory issues.

Area of Science:

  • Pediatric Allergy and Immunology
  • Environmental Health
  • Epidemiology

Background:

  • Early-life exposures critically shape respiratory, allergic, and growth pathways in children.
  • Understanding these influences is key to preventing childhood asthma and allergic diseases.

Purpose of the Study:

  • To systematically review and meta-analyze the impact of various early-life exposures and interventions on asthma, wheeze, atopy, and growth.
  • To identify effective preventive strategies for respiratory and allergic conditions in infants.

Main Methods:

  • A systematic review and meta-analysis of 51 studies.
  • Random effects meta-analyses with inverse variance method to calculate pooled odds ratios (ORs) and 95% confidence intervals (CIs).
  • Assessed heterogeneity using I-squared statistics and publication bias using funnel plots and Egger's test.

Main Results:

  • Maternal influenza vaccination combined with viral prophylaxis significantly protected against wheeze, asthma, and LRTI (OR=0.78).
  • Early-life respiratory viral infections (OR=1.59), allergen/atopy exposures (OR=1.40), environmental exposures (OR=1.34), and infant clinical factors (OR=1.29) increased asthma/wheeze risk.
  • Nutritional interventions during pregnancy and early probiotics showed no significant protective effects.

Conclusions:

  • Early-life exposure to viral infections, allergens, environmental pollutants, and clinical factors strongly influences the development of pediatric respiratory and allergic diseases.
  • Targeted preventive strategies focusing on these risk factors are necessary, as nutritional and probiotic treatments yielded inconsistent results.
Abstract

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