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Long-term impacts of prenatal and infant exposure to fine particulate matter on wheezing and asthma: a systematic review and meta-analysis


Shao, J and Wheeler, AJ and Zosky, GR and Johnston, FH, Long-term impacts of prenatal and infant exposure to fine particulate matter on wheezing and asthma: a systematic review and meta-analysis, Environmental Epidemiology, 3, (2) Article e042. ISSN 2474-7882 (2019) [Refereed Article]


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Copyright 2019 the authors. Licensed under Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0)

DOI: doi:10.1097/EE9.0000000000000042


Background: This systematic review aimed to summarize epidemiologic evidence regarding long-term effects of prenatal and infant particulate matter with an aerodynamic diameter less than 2.5 Ám (PM2.5) exposure on wheezing and asthma.

Methods: data investigating the associations between ambient PM2.5 exposures during prenatal or the first 2 years of life and wheezing or asthma throughout life were extracted from five databases. All included studies were assessed according to the Critical Appraisal Skills Programme checklists. We performed meta-analyses if ≥2 studies estimated the effects of continuous PM2.5.

Results: Nine of 18 eligible studies were suitable for meta-analyses. For prenatal PM2.5 exposure and asthma by 10 years of age (n = 4), the overall risk estimate per 10-unit increase (95% confidence interval) was 1.12 (1.00, 1.26). Although meta-analysis of prenatal exposure and wheezing by 4 years of age (n = 5) was not possible due to inconsistent exposure and outcome assessments, four studies found strong positive associations with wheeze by 2 years of age. The overall risk of developing asthma (n = 5) and wheezing (n = 3) by 8 years of age for infant PM2.5 exposure was 1.14 (0.96, 1.35) and 1.49 (0.99, 2.26), respectively. One large high-quality study reporting risk differences not suitable for meta-analysis demonstrated significant associations between prenatal or infant PM2.5 exposure and childhood asthma. High heterogeneity was present among studies of prenatal exposures and asthma, whereas studies of other associations showed low heterogeneity. There was insufficient evidence about susceptible subgroups.

Conclusions: The limited and inconsistent evidence is suggestive of an association between early life PM2.5 exposure and wheezing/asthma. Large standardized studies are needed to explore the associations and identify vulnerable populations.

Item Details

Item Type:Refereed Article
Keywords:asthma, wheezing, air pollution, meta-analysis, perinatal
Research Division:Biomedical and Clinical Sciences
Research Group:Cardiovascular medicine and haematology
Research Field:Respiratory diseases
Objective Division:Health
Objective Group:Clinical health
Objective Field:Clinical health not elsewhere classified
UTAS Author:Shao, J (Ms Jingyi Shao)
UTAS Author:Wheeler, AJ (Dr Amanda Wheeler)
UTAS Author:Zosky, GR (Professor Graeme Zosky)
UTAS Author:Johnston, FH (Professor Fay Johnston)
ID Code:130591
Year Published:2019
Funding Support:National Health and Medical Research Council (1116412)
Deposited By:Medicine
Deposited On:2019-02-05
Last Modified:2020-09-04
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