Is sibship composition a risk factor for childhood asthma? Systematic review and meta‑analysis

作     者：Daniil Lisik Saliha SelinÖzuygur Ermis Athina Ioannidou Gregorio Paolo Milani Sungkutu Nyassi Giulia Carla Immacolata Spolidoro Hannu Kankaanranta Emma Goksör Göran Wennergren Bright Ibeabughichi Nwaru Daniil Lisik;Saliha Selin Özuygur Ermis;Athina loannidou;Gregorio Paolo Milani;Sungkutu Nyassi;Giulia Carla Immacolata Spolidoro;Hannu Kankaanranta;Emma Goksör;Göran Wennergren;Bright Ibeabughichi Nwaru

作者机构：Krefting Research CentreDepartment of Internal Medicine and Clinical NutritionInstitute of MedicineUniversity of GothenburgMedicinaregatan 1F41390 GöteborgSweden Department of Respiratory MedicineDokuz Eylul UniversityIzmirTurkey Department of Clinical Science and Community HealthUniversity of Milan20122 MilanItaly Pediatric UnitFondazione IRCCS Ca’Granda Ospedale Maggiore Policlinico20122 MilanItaly Tampere University Respiratory Research GroupFaculty of Medicine and Health TechnologyTampere UniversityTampereFinland Department of Respiratory MedicineSeinäjoki Central HospitalSeinäjokiFinland Department of PediatricsSahlgrenska Academy at University of GothenburgGothenburgSweden Wallenberg Centre for Molecular and Translational MedicineUniversity of GothenburgGothenburgSweden 

出 版 物：《World Journal of Pediatrics》 (世界儿科杂志（英文版）)

年 卷 期：2023年第19卷第12期

页      面：1127-1138页

核心收录：

学科分类：1002[医学-临床医学] 100202[医学-儿科学] 10[医学] 

基　　金：Open access funding provided by University of Gothenburg 

主　　题：Asthma Hygiene hypothesis Respiratory sounds Siblings Systematic review 

摘      要：Background Following the“hygiene hypothesis,the role of sibship composition in asthma and wheezing has been extensively studied,but the fndings are *** the frst time,this systematic review and meta-analysis synthesized evidences from studies investigating the association of sibship size and birth order with risk of asthma and *** Fifteen databases were searched to identify eligible *** selection and data extraction were performed independently by pairs of ***-analysis with robust variance estimation(RVE)was used to produce pooled risk ratio(RR)efect estimates from comparable numerical *** From 17,466 identifed records,158 reports of 134 studies(3 million subjects)were *** wheezing in the last≤1.5 years occurred more frequently in infants with≥1 sibling[pooled RR 1.10,95%confdence interval(CI)1.02–1.19]and≥1 older sibling(pooled RR 1.16,95%CI 1.04–1.29).The pooled efect sizes for asthma were overall statistically nonsignifcant,although having≥1 older sibling was marginally protective for subjects aged≥6 years(pooled RR 0.93,95%CI 0.88–0.99).The efect estimates weakened in studies published after 2000 compared with earlier *** Being second-born or later and having at least one sibling is associated with a slightly increased risk of temporary wheezing in *** contrast,being second-born or later is associated with marginal protection against *** associations appear to have weakened since the turn of the millennium,possibly due to lifestyle changes and socioeconomic development.