Socioeconomic circumstances and respiratory function in childhood and adolescence: A systematic review and meta-analysis

Abstract

Introduction Childhood and adolescence seem to be a critical time for respiratory health, as during this period the foundations for development and growth are laid, and adverse life factors such as disadvantaged socioeconomic circumstances were associated with lung function poorer growth and faster decline. Therefore, this study aimed to summarise the evidence on the association between socioeconomic circumstances and respiratory function in children and adolescents. Methods A systematic review and meta-analysis was conducted following the PRISMA guidelines. Pubmed, ISI-Web of Science, and Scopus were searched from inception up to 24th March 2017. Original studies addressing the association between socioeconomic circumstances and respiratory function early in life (i.e. including children and adolescents less than 25 years of age) were investigated. Two investigators independently evaluated articles, applied the exclusion criteria, and extracted data. A meta-analysis of the standardized mean difference in respiratory function between adolescents from different socioeconomic circumstances was also conducted using a random effects model. Between-study heterogeneity was quantified using I-squared statistics. Results Disadvantaged socioeconomic circumstances were significantly associated with a reduction in respiratory function indices during childhood and adolescence, observed in 21 of the 31 included studies. The meta-analysis showed a significant difference of −0.26 litres (95% confidence intervals: −0.38; −0.15) in forced expiratory volume in first second between children and adolescents from disadvantaged versus advantaged socioeconomic circumstances. Conclusion Children and adolescents from disadvantaged socioeconomic circumstances presented a significant reduction in respiratory function. This information help to explain the social patterning of respiratory diseases during adulthood and older ages and might contribute to inform policies to prevent respiratory health inequalities from early ages.