Department of Pediatrics, Shengjing Hospital of China Medical University, Sanhao Street, Heping District, Shenyang, China.
Department of Neurology, Shengjing Hospital of China Medical University, Shenyang, China.
World J Pediatr. 2023 Jun;19(6):549-556. doi: 10.1007/s12519-023-00701-1. Epub 2023 Mar 1.
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.
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.
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 = 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).
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.
本研究旨在系统回顾和荟萃分析现有文献，探讨早产儿支气管肺发育不良（BPD）与成年前哮喘之间的关联。
系统检索了 Scopus、Embase、Web of Science、PubMed 和 Cochrane Library 数据库，以获取从数据库建立到 2022 年 3 月 26 日期间发表的研究，评估 BPD 与儿童和青少年哮喘之间的关联，并进行荟萃分析。我们使用荟萃分析计算 BPD 与成年前发生哮喘的概率之间的相关性，采用合并比值比（OR）估计值。采用 Stata 12.0 进行统计分析。
9 项研究评估了早产儿支气管肺发育不良与哮喘之间的相关性。我们采用随机效应模型对合并 OR 估计值进行分析。结果表明，BPD 早产儿发生后续哮喘的风险显著增加[OR=1.73，95%置信区间（CI）=1.43-2.09]。此外，各研究之间无明显异质性（P=0.617，I²=0%）。汇总的 OR 较为稳定，范围在 1.65（95% CI=1.35-2.01）至 1.78（95% CI=1.43-2.21）之间。关于发表偏倚，哮喘风险的漏斗图未显示明显的不对称性。我们进一步进行 Begg 和 Egger 检验以定量评估发表偏倚。哮喘风险的发表偏倚无统计学意义（Begg 检验 P>0.602，Egger 检验 P>0.991）。
本研究结果表明，患有 BPD 的早产儿未来发生哮喘的风险更高（OR=1.73，95% CI=1.43-2.09）。患有 BPD 的早产儿可能需要长期随访。
