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Siblings and risk of allergic rhinitis: a systematic review and meta-analysis
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  • Daniil Lisik,
  • Saliha Selin Özuygur Ermis,
  • Athina Ioannidou,
  • Gregorio Milani,
  • Sungkutu Nyassi,
  • Giulia Carla Immacolata Spolidoro,
  • Hannu Kankaanranta,
  • Emma Goksör,
  • Göran Wennergren,
  • Bright Nwaru
Daniil Lisik
Goteborgs universitet Avdelningen for invartesmedicin och klinisk nutrition

Corresponding Author:[email protected]

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Saliha Selin Özuygur Ermis
Goteborgs universitet Avdelningen for invartesmedicin och klinisk nutrition
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Athina Ioannidou
Goteborgs universitet Avdelningen for invartesmedicin och klinisk nutrition
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Gregorio Milani
Universita degli Studi di Milano Dipartimento di Scienze Cliniche e di Comunita
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Sungkutu Nyassi
Goteborgs universitet Avdelningen for invartesmedicin och klinisk nutrition
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Giulia Carla Immacolata Spolidoro
Universita degli Studi di Milano Dipartimento di Scienze Cliniche e di Comunita
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Hannu Kankaanranta
Goteborgs universitet Avdelningen for invartesmedicin och klinisk nutrition
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Emma Goksör
Goteborgs universitet Sahlgrenska Akademin
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Göran Wennergren
Goteborgs universitet Avdelningen for invartesmedicin och klinisk nutrition
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Bright Nwaru
Goteborgs universitet Avdelningen for invartesmedicin och klinisk nutrition
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Abstract

Introduction: Following the “hygiene hypothesis” and the increase in prevalence of atopic diseases such as allergic rhinitis, a plethora of studies have investigated the role of sibship composition as a protective factor, but findings are conflicting. Aim: To synthesize the global literature linking birth order and sibship size (number of siblings) to the risk of allergic rhinitis. Methods: Fifteen databases were systematically searched, with no restrictions on publication date or language. Observational studies with defined sibship composition (birth order or sibship size) as exposure and allergic rhinitis or allergic rhinoconjunctivitis (self-reported or clinically diagnosed) as outcome were eligible. Study selection, data extraction, and quality assessment was performed independently in pairs. Relevant data were summarized in tables. Comparable numerical data were analyzed using meta-analysis with robust variance estimation (RVE). Results: Seventy-six reports with >2 million subjects were identified. Being second- or later-born child was associated with protection against both current (pooled risk ratio [RR] 0.79, 95%CI 0.73-0.86) and ever (RR 0.77, 95%CI 0.68-0.88) allergic rhinitis. Having siblings, regardless of birth order, was associated with a decreased risk of current allergic rhinitis (RR 0.89, 95% CI 0.83-0.95) and allergic rhinoconjunctivitis (RR 0.92, 95%CI 0.86-0.98). These effects were unchanged across age, time period, and geographical regions. Conclusion: Our findings indicate that primarily, a higher birth order, and to a lesser extent the number of siblings, is associated with a lower risk of developing allergic rhinitis.
10 May 2023Submitted to Pediatric Allergy and Immunology
11 May 2023Submission Checks Completed
11 May 2023Assigned to Editor
11 May 2023Review(s) Completed, Editorial Evaluation Pending
12 May 2023Reviewer(s) Assigned
08 Jun 2023Editorial Decision: Revise Minor
19 Jun 20231st Revision Received
20 Jun 2023Submission Checks Completed
20 Jun 2023Assigned to Editor
20 Jun 2023Review(s) Completed, Editorial Evaluation Pending
22 Jun 2023Editorial Decision: Accept