Risk of asthma in preterm infants with bronchopulmonary dysplasia: a systematic review and meta-analysis

Abstract

Background This study aimed to systematically review and meta-analyze the available literature on the association between preterm infant bronchopulmonary dysplasia (BPD) and pre-adulthood asthma. Methods Studies examining the association between BPD and asthma in children and adolescents were systematically reviewed, and a meta-analysis was conducted. We searched Scopus, Embase, Web of Science, PubMed, and Cochrane Library from the database inception to March 26, 2022. The pooled odds ratio (OR) estimate was used in our meta-analysis to calculate the correlation between BPD and the probability of developing asthma before adulthood. Stata 12.0 was used to conduct the statistical analysis. Results The correlation between asthma and BPD in preterm newborns was examined in nine studies. We used a random effect model to pool the OR estimate. Our results indicated a marked increase in the risk of subsequent asthma in preterm infants with BPD [OR = 1.73, 95% confidence interval (CI) = 1.43–2.09]. Moreover, there was no obvious heterogeneity across the studies (P = 0.617, I2 = 0%). The pooled OR remained stable and ranged from 1.65 (95% CI = 1.35–2.01) to 1.78 (95% CI = 1.43–2.21). Regarding publication bias, the funnel plot for asthma risk did not reveal any noticeable asymmetry. We further performed Begg’s and Egger’s tests to quantitatively evaluate publication bias. There was no evidence of a publication bias for asthma risk (P > |Z| = 0.602 for Begg’s test, and P > |t| = 0.991 for Egger’s test). Conclusions Our findings indicate that preterm infants with BPD have a much higher risk of developing asthma in the future (OR = 1.73, 95% CI = 1.43–2.09). Preterm infants with BPD may benefit from long-term follow-up.

Effects of early postnatal hyperoxia exposure combined with early ovalbumin sensitization on lung inflammation and bacterial flora in a juvenile mouse model of asthma

“…Since the 1980s, the incidence of BPD has shown an increase, especially as neonatal monitoring and the survival of extremely preterm infants have improved. BPD in preterm infants may be a major risk factor for the future development of asthma in childhood ( Sun et al, 2023 ). Therefore, the use of early hyperoxia exposure in neonatal mice (BPD model) combined with early ovalbumin (OVA) sensitization can help in understanding the relationship between late childhood BPD and asthma development and formulating effective treatments.…”

Phenotype wide association study links bronchopulmonary dysplasia with eosinophilia in children

“…These ndings are consistent with epidemiological data showing increased asthma incidence in children with BPD, and family history of asthma being a risk factor for asthma diagnosis in BPD children. 30 Speci cally, our ndings highlight the signi cance of two intronic SNPs, rs3771150 and rs3771171, within the IL1RL1 and IL18R1 genes. These SNPs, initially identi ed by Floros et al in an African American cohort, were successfully linked to eosinophil percentage in our pediatric cohort, a relationship validated externally.…”

Risk of childhood asthma in those born small

“…It is reasonable to say that the overall literature on this topic shows that prematurity is a plausible risk factor for development of asthma and associated poor lung function later in life, but possibly more so in those patients who were born very preterm and complicated by BPD in the first few months-years of life, as highlighted in numerous systematic reviews. [5][6][7][8] In this research article by Kim et al, a decrease in lung function in children with asthma was observed as the birth weight for gestation decreased, and this was noticed in both ex-term and preterm patients on univariate comparison. The authors aimed to assess the independent impact of FGR on lung function but were constrained by the limited number of factors that could be included in the regression analysis.…”

“…To summarize, the assessment of impact of prematurity on lung function in the current study may be potentially biased by selection of relatively mature preterm babies. It is reasonable to say that the overall literature on this topic shows that prematurity is a plausible risk factor for development of asthma and associated poor lung function later in life, but possibly more so in those patients who were born very preterm and complicated by BPD in the first few months–years of life, as highlighted in numerous systematic reviews 5–8 …”