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

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, I(2) = 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. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s12519-023-00701-1.