Early preterm birth linked to lower atopic dermatitis risk in large meta-analysis
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Key Takeaway
Consider gestational age as a factor in allergy risk assessment, but interpret associations cautiously due to observational data.
This meta-analysis of observational studies examined the association between gestational age at birth and the risk of atopic dermatitis (AD) and allergic rhinitis (AR) in children. The analysis included data from over 5 million newborns and children. The primary outcome was the risk of developing AD and AR based on gestational age categories: early preterm, preterm, and post-term compared to full-term birth.
The authors found that early preterm birth was associated with a reduced risk of AD, and preterm birth also showed a reduced risk. In contrast, post-term birth was associated with an increased risk of AD. For AR, early preterm birth was suggestively associated with a reduced risk. All results were reported as odds ratios with confidence intervals.
Key limitations include the observational nature of the included studies, which precludes establishing causality. The authors note that subgroup and sensitivity analyses were performed, but specific limitations were not detailed in the abstract. The findings highlight the perinatal period as a critical window for allergy risk stratification and early prevention strategies.
Clinicians should interpret these associations cautiously, recognizing that the absolute risk differences are not reported and that confounding factors may influence the results. The study underscores the need for further research to understand the underlying mechanisms.
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View Original Abstract ↓
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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