Association between early bronchiolitis and the development of childhood asthma: a meta-analysis

OBJECTIVE: Early life bronchiolitis has been hypothesised to be associated with the subsequent risk of persistent wheezing or asthma. However, the link remains controversial. The objective of our study was to evaluate the association between bronchiolitis before 2 years of age and the late-onset whe...

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Autores principales: Wang, Guizuo, Han, Dong, Jiang, Zhengdong, Li, Manxiang, Yang, Shumei, Liu, Lu
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8166632/
https://www.ncbi.nlm.nih.gov/pubmed/34049905
http://dx.doi.org/10.1136/bmjopen-2020-043956
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author Wang, Guizuo
Han, Dong
Jiang, Zhengdong
Li, Manxiang
Yang, Shumei
Liu, Lu
author_facet Wang, Guizuo
Han, Dong
Jiang, Zhengdong
Li, Manxiang
Yang, Shumei
Liu, Lu
author_sort Wang, Guizuo
collection PubMed
description OBJECTIVE: Early life bronchiolitis has been hypothesised to be associated with the subsequent risk of persistent wheezing or asthma. However, the link remains controversial. The objective of our study was to evaluate the association between bronchiolitis before 2 years of age and the late-onset wheezing/asthma. DESIGN: Systematic review and meta-analysis. METHODS: PubMed, Embase and Web of Science databases were systematically searched for studies published between 1955 and January 2020. Meanwhile, we also checked through the reference lists of relevant articles to see whether these references included reports of other studies that might be eligible for the review. Cohort and case–control studies assessing the association between early-life bronchiolitis and late-onset wheezing/asthma were included in this meta-analysis. Data were extracted by two independent reviewers. Results were pooled using a random-effects model or fixed-effects model according to the heterogeneity among studies. RESULTS: 32 original articles with 292 844 participants, which met the criteria, were included in this meta-analysis. Bronchiolitis before 2 years of age was associated with an increased risk of subsequent wheezing/asthma (relative risk=2.46, 95% CI 2.14 to 2.82, p<0.001). After categorising studies into different groups based on age at the end of follow-up, geographical region and study quality, the association still remained significant. CONCLUSIONS: The meta-analysis indicates an association between bronchiolitis before 2 years of age and the wheezing/asthma in later life. Well-designed and highly standardised prospective studies that better address bias due to potential confounding factors are needed to validate the risk identified in our meta-analysis. PROSPERO registration number CRD42018089453.
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spelling pubmed-81666322021-06-14 Association between early bronchiolitis and the development of childhood asthma: a meta-analysis Wang, Guizuo Han, Dong Jiang, Zhengdong Li, Manxiang Yang, Shumei Liu, Lu BMJ Open Respiratory Medicine OBJECTIVE: Early life bronchiolitis has been hypothesised to be associated with the subsequent risk of persistent wheezing or asthma. However, the link remains controversial. The objective of our study was to evaluate the association between bronchiolitis before 2 years of age and the late-onset wheezing/asthma. DESIGN: Systematic review and meta-analysis. METHODS: PubMed, Embase and Web of Science databases were systematically searched for studies published between 1955 and January 2020. Meanwhile, we also checked through the reference lists of relevant articles to see whether these references included reports of other studies that might be eligible for the review. Cohort and case–control studies assessing the association between early-life bronchiolitis and late-onset wheezing/asthma were included in this meta-analysis. Data were extracted by two independent reviewers. Results were pooled using a random-effects model or fixed-effects model according to the heterogeneity among studies. RESULTS: 32 original articles with 292 844 participants, which met the criteria, were included in this meta-analysis. Bronchiolitis before 2 years of age was associated with an increased risk of subsequent wheezing/asthma (relative risk=2.46, 95% CI 2.14 to 2.82, p<0.001). After categorising studies into different groups based on age at the end of follow-up, geographical region and study quality, the association still remained significant. CONCLUSIONS: The meta-analysis indicates an association between bronchiolitis before 2 years of age and the wheezing/asthma in later life. Well-designed and highly standardised prospective studies that better address bias due to potential confounding factors are needed to validate the risk identified in our meta-analysis. PROSPERO registration number CRD42018089453. BMJ Publishing Group 2021-05-28 /pmc/articles/PMC8166632/ /pubmed/34049905 http://dx.doi.org/10.1136/bmjopen-2020-043956 Text en © Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) .
spellingShingle Respiratory Medicine
Wang, Guizuo
Han, Dong
Jiang, Zhengdong
Li, Manxiang
Yang, Shumei
Liu, Lu
Association between early bronchiolitis and the development of childhood asthma: a meta-analysis
title Association between early bronchiolitis and the development of childhood asthma: a meta-analysis
title_full Association between early bronchiolitis and the development of childhood asthma: a meta-analysis
title_fullStr Association between early bronchiolitis and the development of childhood asthma: a meta-analysis
title_full_unstemmed Association between early bronchiolitis and the development of childhood asthma: a meta-analysis
title_short Association between early bronchiolitis and the development of childhood asthma: a meta-analysis
title_sort association between early bronchiolitis and the development of childhood asthma: a meta-analysis
topic Respiratory Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8166632/
https://www.ncbi.nlm.nih.gov/pubmed/34049905
http://dx.doi.org/10.1136/bmjopen-2020-043956
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