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The aim of this study was to synthesize the global literature linking birth order and sibship size (number of siblings) to the risk of allergic rhinitis. 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\u2010reported or clinically diagnosed) as outcome were eligible. Study selection, data extraction, and quality assessment were performed independently in pairs. Relevant data were summarized in tables. Comparable numerical data were analyzed using meta\u2010analysis with robust variance estimation (RVE). Seventy\u2010six reports with &gt;2\u2009million subjects were identified. Being second\u2010 or later\u2010born child was associated with protection against both current (pooled risk ratio [RR] 0.79, 95% CI 0.73\u20130.86) and ever (RR 0.77, 95% CI 0.68\u20130.88) 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\u20130.95) and allergic rhinoconjunctivitis (RR 0.92, 95% CI 0.86\u20130.98). These effects were unchanged across age, time period, and geographical regions. Our findings thus 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.<\/jats:p>","DOI":"10.1111\/pai.13991","type":"journal-article","created":{"date-parts":[[2023,7,3]],"date-time":"2023-07-03T08:22:32Z","timestamp":1688372552000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["Siblings and risk of allergic rhinitis: A systematic review and meta\u2010analysis"],"prefix":"10.1111","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0220-5961","authenticated-orcid":false,"given":"Daniil","family":"Lisik","sequence":"first","affiliation":[{"name":"Krefting Research Centre, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine University of Gothenburg  Gothenburg 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