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Type: Journal article
Title: Relationship between birth weight or fetal growth rate and postnatal allergy: a systematic review
Author: Wooldridge, A.L.
McMillan, M.
Kaur, M.
Giles, L.C.
Marshall, H.S.
Gatford, K.L.
Citation: Journal of Allergy and Clinical Immunology, 2019; 144(6):1703-1713
Publisher: Elsevier
Issue Date: 2019
ISSN: 0091-6749
Statement of
Amy L. Wooldridge, Mark McMillan, Manpreet Kaur, Lynne C. Giles, Helen S. Marshall and Kathryn L. Gatford
Abstract: Background: Individual susceptibility to allergic diseases is developmentally programmed by early-life exposures. Evidence from preclinical studies suggests that intrauterine growth restriction is protective against later inflammatory responses to allergens. Objective: We sought to evaluate whether prenatal growth affects susceptibility to allergy in human subjects. Methods: We systematically searched for relevant studies in 11 databases, including Web of Science, ProQuest, EMBASE, and PubMed. We included only studies that corrected for gestational age or were restricted to full-term infants to separate effects of fetal growth from those of prematurity. Results: The 42 eligible studies included prospective and retrospective cohort, cross-sectional, and case-control studies. Only 2 studies reported allergic asthma. A birth weight increase of 1 kg was associated with a 44% greater risk of food allergy in children (odds ratio [OR], 1.44; 95% CI, 1.04-1.99; P = .001), a 17% greater risk of ever allergic dermatitis in children (OR, 1.17; 95% CI, 1.04-1.32; P = .008), and a 34% greater risk of ever or current allergic dermatitis in infants up to 2 years of age (OR, 1.34; 95% CI, 1.08-1.68; P = .009). Risks of allergic rhinitis were not associated with birth weight. Conclusions: The results of these meta-analyses suggest that intrauterine growth restriction protects against allergic diseases in human subjects consistent with preclinical evidence but that effects might differ between allergic diseases. The strongest evidence is available for infancy and early childhood, and additional studies in older children and adults are needed to determine whether the effects of prenatal growth on each allergic disease persist or differ between those with severe and mild phenotypes.
Keywords: Birth weight; systematic review; eczema; allergic rhinitis; food allergy; allergic asthma
Rights: © 2019 American Academy of Allergy, Asthma & Immunology
DOI: 10.1016/j.jaci.2019.08.032
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