Impact of perinatal risk factors on pediatric asthma: A systematic review and meta-analysis

Background: Childhood asthma is a common chronic disease in children, which has a double negative impact on children's physical and mental health, and also brings a heavy economic burden to children's families. Maternal indicators during the perinatal period are the key inducement for the occurrence and severity of asthma in children. However, people's lack of awareness of the risk factors that may affect the occurrence of childhood asthma during the perinatal period and effective intervention measures have become the reasons and loopholes for the rising prevalence of childhood asthma. Objective: This systematic review and meta-analysis investigated the influence of perinatal risk factors on pediatric asthma (PA) to provide evidence for optimizing perinatal management and prevention strategies. Methods: The study was conducted in accordance with the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). A retrospective search of medical literature data bases was conducted up to April 24, 2024, for observational studies on the impact of perinatal risk factors on PA. A meta-analysis was conducted by using a random or fixed effects model based on the Cochran Q test and I2 statistics. Results: A total of 26 observational studies with 2,143,844 participants were included. The meta-analysis identified maternal perinatal smoking (odds ratio [OR] 1.11 [95% confidence interval {CI}, 1.01‐1.24]; p = 0.04), gestational age of <37 weeks (OR 1.50 [95% CI, 1.36‐1.65]; p < 0.0001), maternal asthma history (OR 1.80 [95% CI, 1.29‐2.52]; p = 0.001), and maternal perinatal antibiotic use (OR 1.82 [95% CI, 1.01‐3.29]; p = 0.047) as significant risk factors. Multivariate analysis further highlighted maternal smoking (OR 1.83 [95% CI, 1.23‐2.72]; p = 0.003) and maternal asthma history (OR 4.49 [95% CI, 2.49‐8.12]; p < 0.0001) as key risks. Conclusion: Smoking by mothers, gestational age at birth of <37 weeks, asthma history of mothers, and perinatal use of antibiotics by mothers were all risk factors for PA. Targeted interventions are needed to mitigate these risks.