The risk factors for chronic cough in children: A meta-analysis covering five continents

Background: This study aimed to explore the risk factors for chronic cough in children and provide a reference for prevention and healthcare measures. Methods: PubMed, Web of Science, Cochrane, and EMBASE were searched for observational studies published up to April 2024. Outcome included risk factors associated with chronic cough in children. Two investigators independently searched and screened the literature, evaluated the qualities and extracted baseline datas. Results were analyzed using random-effects models with odds ratios and their 95 % confidence intervals to address heterogeneity. Subgroup analyses, sensitivity analyses and assessment of publication bias were performed. Stata17 and GRADEwas used for the meta-analysis. Results: 18 studies including 97,462 children were reviewed. Asthma(OR = 4.06, 95%CI: 2.37-6.96, P<0.01), NO2(OR = 1.19, 95%CI: 1.01-1.39, P = 0.031), Home remodeling history (OR = 1.82,95% CI: 1.61-2.05, P< 0.01), Environment Tobacco Smoke(OR = 1.41, 95% CI: 1.15-1.73, P = 0.001), Pet exposure (OR = 1.56, 95% CI: 1.25-1.95, P<0.01), Mould (OR = 1.64,95%CI: 1.45-1.85, P<0.01), Age<1 year(OR = 3.19, 95 % CI: 1.8-5.63, P<0.01) were reported as risk factors for chronic cough in children, these results were discussed qualitatively in the study. Conclusion: Asthma, NO2, Home remodeling history, Environment Tobacco Smoke(ETS), Pet exposure, Mould, and Age<1 year are risk factors for chronic coughing in children. Due to the few studies and insufficient evidence, other potential risk factors need to be robustly confirmed by subsequent large-sample and multicenter trials.