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Review Article

Risk factors associated with uncontrolled asthma in children – a systematic review and meta-analysis

, MD (Pediatrics)ORCID Icon, , PhD (Pediatrics)ORCID Icon & , MSc (Pediatrics)ORCID Icon
Pages 387-395 | Received 05 Oct 2023, Accepted 19 Nov 2023, Published online: 04 Dec 2023
 

Abstract

Objective

We aim to assess the risk factors of uncontrolled asthma in children and adolescents.

Methods

A systemic search was conducted from electronic databases (PubMed/Medline, Cochrane Library, and Google Scholar) from inception to July 17, 2023. All statistical analyses were conducted in Review Manager 5.4.1. Studies meeting inclusion criteria were selected. A random-effects model was used when heterogeneity was seen to pool the studies, and the result was reported in the odds ratio and the corresponding 95% confidence interval. We also used a narrative approach where it was not feasible to quantitatively assess the outcome.

Results

Ten observational studies were used to conduct this systematic review and meta-analysis. A quantitative analysis of five factors was done. Pooled analysis showed a statistically significant risk of uncontrolled asthma in association with past hypersensitivity reactions (standardized mean difference [SMD] = 1.51 (1.16, 1.98); p = .002; I2 = 84%) and incomplete controller adherence (SMD = 3.15 (1.83, 5.41); p < .0001; I2 = 94%). While non-significant relation was seen in parental asthma (SMD = 1.23 (0.98, 1.55); p = .07; I2 = 15%), oral corticosteroid use (SMD = 0.99 (0.72, 1.36); p = .96; I2 = 81%) and education of caregivers (SMD = 0.99 (0.72, 1.36); p = .96; I2 = 81%). Some other factors were also discussed qualitatively.

Conclusion

Our study shows that some significant risk factors might cause uncontrolled asthma in children and adolescents like past hypersensitivity reactions and incomplete controller adherence.

Disclosure statement

The authors accept all conditions and publication rights. All authors have approved the manuscript and its submission to the journal. They have no conflict of interest to declare.

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.

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