BACKGROUND: Preterm birth, low birth weight, and infant catch-up growth seem associated with an increased risk of respiratory diseases in later life, but individual studies showed conflicting results. OBJECTIVES: We performed an individual participant data meta-analysis for 147,252 children of 31 birth cohort studies to determine the associations of birth and infant growth characteristics with the risks of preschool wheezing (1-4 years) and school-age asthma (5-10 years). METHODS: First, we performed an adjusted 1-stage random-effect meta-analysis to assess the combined associations of gestational age, birth weight, and infant weight gain with childhood asthma. Second, we performed an adjusted 2-stage random-effect meta-analysis to assess the associations of preterm birth (gestational age <37 weeks) and low birth weight (<2500 g) with childhood asthma outcomes. RESULTS: Younger gestational age at birth and higher infant weight gain were independently associated with higher risks of preschool wheezing and school-age asthma (P < .05). The inverse associations of birth weight with childhood asthma were explained by gestational age at birth. Compared with term-born children with normal infant weight gain, we observed the highest risks of school-age asthma in children born preterm with high infant weight gain (odds ratio [OR], 4.47; 95% CI, 2.58-7.76). Preterm birth was positively associated with an increased risk of preschool wheezing (pooled odds ratio [pOR], 1.34; 95% CI, 1.25-1.43) and school-age asthma (pOR, 1.40; 95% CI, 1.18-1.67) independent of birth weight. Weaker effect estimates were observed for the associations of low birth weight adjusted for gestational age at birth with preschool wheezing (pOR, 1.10; 95% CI, 1.00-1.21) and school-age asthma (pOR, 1.13; 95% CI, 1.01-1.27). CONCLUSION: Younger gestational age at birth and higher infant weight gain were associated with childhood asthma outcomes. The associations of lower birth weight with childhood asthma were largely explained by gestational age at birth.

Applied Health Sciences University of Aberdeen Aberdeen United Kingdom

Cancer Epidemiology Unit Department of Medical Sciences University of Turin Turin Italy

Centre for Prevention and Health Services Research National Institute for Public Health and the Environment Bilthoven The Netherlands

Clinical and Experimental Sciences Academic Unit Faculty of Medicine University of Southampton Southampton United Kingdom

Copenhagen Prospective Studies on Asthma in Childhood Faculty of Health Sciences University of Copenhagen Copenhagen Denmark; Danish Pediatric Asthma Center Copenhagen University Hospital Gentofte Denmark

David Hide Asthma and Allergy Research Centre St Mary's Hospital Newport Isle of Wight United Kingdom

Department of Biomedical and Neuromotor Sciences University of Bologna Bologna Italy

Department of Biostatistics Erasmus Medical Center Rotterdam The Netherlands; Institute of Pedagogical Sciences Erasmus University Rotterdam Rotterdam The Netherlands; Institute of Psychology Erasmus University Rotterdam Rotterdam The Netherlands

Department of Clinical Epidemiology Predictive Medicine and Public Health University of Porto Medical School Porto Portugal

Department of Environmental Medicine Faculty of Public Health Slovak Medical University Bratislava Slovakia

Department of Epidemiology CAPHRI School for Public Health and Primary Care Maastricht University Maastricht The Netherlands

Department of Epidemiology Erasmus Medical Center Rotterdam The Netherlands; Department of Paediatrics Division of Respiratory Medicine Erasmus Medical Center Rotterdam The Netherlands; Department of Paediatrics Division of Neonatology Erasmus Medical Center Rotterdam The Netherlands

Department of Epidemiology Lazio Regional Health Service Rome Italy

Department of Epidemiology University of Groningen University Medical Center Groningen Groningen The Netherlands

Department of Genes and Environment Division of Epidemiology Norwegian Institute of Public Health Oslo Norway

Department of Paediatric Pneumology and Immunology Charité University Medical Centre Berlin Germany

Department of Paediatric Pulmonology Wilhelmina Children's Hospital University Medical Center Utrecht Utrecht The Netherlands

Department of Paediatrics Division of Respiratory Medicine Erasmus Medical Center Rotterdam The Netherlands

Department of Social Medicine School of Medicine University of Crete Crete Greece

Division of Pediatrics Department of Clinical and Experimental Medicine Linköping University and Pediatric Clinic County Council of Östergötland County Council Linköping Sweden

Division of Respiratory Medicine Department of Pediatrics Inselspital University of Bern Bern Switzerland

EPAR UMR S 707 INSERM Paris Paris France; EPAR UMR S 707 Université Pierre et Marie Curie Paris 06 Paris France

Generation R Study Group Erasmus Medical Center Rotterdam The Netherlands; Department of Epidemiology Erasmus Medical Center Rotterdam The Netherlands; Department of Paediatrics Division of Respiratory Medicine Erasmus Medical Center Rotterdam The Netherlands

Generation R Study Group Erasmus Medical Center Rotterdam The Netherlands; Department of Epidemiology Erasmus Medical Center Rotterdam The Netherlands; Department of Paediatrics Erasmus Medical Center Rotterdam The Netherlands

IB SALUT Area de Salut de Menorca Balearic Islands Spain

INSERM Center for Research in Epidemiology and Population Health U1018 Lifelong Epidemiology Of Obesity Diabetes and Renal Disease Team Villejuif France; University Paris Sud Villejuif France

Institute for Risk Assessment Sciences Utrecht University Utrecht The Netherlands

Institute of Experimental Medicine Academy of Sciences of the Czech Republic Prague Czech Republic

Institute of Social and Preventive Medicine University of Bern Bern Switzerland

Institute of Social Medicine Epidemiology and Health Economics Charité University Medical Center Berlin Germany; Institute for Clinical Epidemiology and Biometry University of Würzburg Würzburg Germany

MRC Lifecourse Epidemiology Unit University of Southampton Southampton General Hospital Southampton United Kingdom

National School of Public Health Athens Greece

Nofer Institute of Occupational Medicine Department of Environmental Epidemiology Lodz Poland

Public Health Division of Gipuzkoa Gipuzkoa Spain; Spanish Consortium for Research on Epidemiology and Public Health Barcelona Spain

School of Public Health Physiotherapy and Population Science University College Dublin Dublin Ireland

School of Social and Community Medicine University of Bristol Bristol United Kingdom

Section of Social Medicine Department of Public Health University of Copenhagen Copenhagen Denmark

Spanish Consortium for Research on Epidemiology and Public Health Barcelona Spain; Department of Experimental and Health Sciences Pompeu Fabra University Barcelona Spain

Spanish Consortium for Research on Epidemiology and Public Health Hospital del Mar Barcelona Spain

Spanish Consortium for Research on Epidemiology and Public Health University of Valencia Valencia Spain; Faculty of nursery and chiropody University of Valencia Valencia Spain

University Children's Hospital Basel University of Basel Basel Switzerland

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