Early-Life Respiratory Infections and Maternal Allergy: Driving Factors in Childhood Asthma

Neonatal RSV exposure combined with maternal allergic disease is associated with a higher risk of childhood asthma—indicating that specific early-life exposures can materially alter later respiratory outcomes and warrant prevention-focused consideration.

A recent review that pooled large epidemiologic cohorts alongside mechanistic mouse models reports an association between parental allergy plus neonatal RSV exposure and increased childhood asthma risk; the authors frame this as a convergent epidemiologic and experimental signal while noting heterogeneity across the primary studies.

Mechanistic evidence summarized in the review suggests maternally transferred antibodies can modulate neonatal immune priming. Several mouse-model studies report antibody-associated amplification of airway inflammation and subsequent airway hyperresponsiveness after neonatal RSV exposure; the review synthesizes these primary experiments rather than presenting new animal data.

Preventing early-life RSV infection may therefore reduce downstream allergic sensitization, especially among infants born to mothers with allergic disease. The targeted use of nirsevimab in definable high-risk infants is a plausible strategy to test. Immunoprophylaxis already prevents acute severe RSV, but evidence that it reduces long-term asthma risk is provisional and requires confirmatory trials—so prioritizing targeted prophylaxis for infants with maternal allergy could be justified only within research or registry frameworks pending trial results.