Caesarean section delivery and the risk of allergic disorders in childhood

H. Renz-Polster, M. R. David, A (Sonia) Buist, W. M. Vollmer, E. A. O'Connor, E. A. Frazier, Michael Wall

Research output: Contribution to journalArticle

177 Citations (Scopus)

Abstract

Background: The composition of the intestinal flora in young children, if unfavourable, may increase the susceptibility to allergic disorders. Beneficial intestinal microbes originate from the maternal vaginal tract and thus are more likely to be transferred during vaginal births than during Caesarean sections (C-sections). Objective: To determine whether children born by C-section have a different risk of allergic disorders compared with those delivered vaginally. We also tested the hypothesis that the risk of allergic disorders is highest for children born after 'repeat C-sections'. Methods: A retrospective cohort study of 8953 children aged 3-10 years. Children diagnosed with allergic rhinoconjunctivitis (AR), asthma, atopic dermatitis (AD), or food allergies were identified from the Kaiser Permanente Northwest Region electronic records. The children's sex, birth weight, birth order, postnatal exposure to antibiotics as well as the mothers' age, ethnicity, education, marital status, smoking status during pregnancy, and use of asthma or hayfever medications were identified through the mothers' medical records or through the Oregon Birth Registry. Results: The risk of being diagnosed with AR was significantly higher in the children born by C-section than in those delivered vaginally: adjusted odds ratio (OR)=1.37%, 95% confidence interval (CI)=1.14-1.63. Delivery by C-section was also associated with the subsequent diagnosis of asthma (OR=1.24%, 95% CI=1.01-1.53); this association was gender specific, with a positive association restricted to girls (OR for asthma in girls: OR=1.53%, 95% CI=1.11-2.10; in boys: OR=1.08%, 95% CI=0.81-1.43). There was no significant association between mode of delivery and AD. If children born in a 'repeat C-section' were considered separately the risk of being diagnosed with AR increased further (OR=1.78%, 95% CI=1.34-2.37). The same increase was noted for asthma in girls (OR=1.83%, 95% CI=1.13-2.97) but not in boys. Conclusion: Caesarean sections may be associated with an increased risk of developing AR in childhood.

Original languageEnglish (US)
Pages (from-to)1466-1472
Number of pages7
JournalClinical and Experimental Allergy
Volume35
Issue number11
DOIs
StatePublished - Nov 2005

Fingerprint

Cesarean Section
Odds Ratio
Confidence Intervals
Asthma
Repeat Cesarean Section
Mothers
Atopic Dermatitis
Parturition
Birth Order
Seasonal Allergic Rhinitis
Food Hypersensitivity
Marital Status
Birth Weight
Medical Records
Registries
Cohort Studies
Retrospective Studies
Smoking
Anti-Bacterial Agents
Education

Keywords

  • Allergic rhinoconjunctivitis
  • Allergy
  • Asthma
  • Atopic dermatitis
  • Atopy
  • Caesarean section
  • Intestinal flora
  • Intestinal microbes
  • Risk of allergic disorders

ASJC Scopus subject areas

  • Immunology

Cite this

Renz-Polster, H., David, M. R., Buist, A. S., Vollmer, W. M., O'Connor, E. A., Frazier, E. A., & Wall, M. (2005). Caesarean section delivery and the risk of allergic disorders in childhood. Clinical and Experimental Allergy, 35(11), 1466-1472. https://doi.org/10.1111/j.1365-2222.2005.02356.x

Caesarean section delivery and the risk of allergic disorders in childhood. / Renz-Polster, H.; David, M. R.; Buist, A (Sonia); Vollmer, W. M.; O'Connor, E. A.; Frazier, E. A.; Wall, Michael.

In: Clinical and Experimental Allergy, Vol. 35, No. 11, 11.2005, p. 1466-1472.

Research output: Contribution to journalArticle

Renz-Polster, H, David, MR, Buist, AS, Vollmer, WM, O'Connor, EA, Frazier, EA & Wall, M 2005, 'Caesarean section delivery and the risk of allergic disorders in childhood', Clinical and Experimental Allergy, vol. 35, no. 11, pp. 1466-1472. https://doi.org/10.1111/j.1365-2222.2005.02356.x
Renz-Polster, H. ; David, M. R. ; Buist, A (Sonia) ; Vollmer, W. M. ; O'Connor, E. A. ; Frazier, E. A. ; Wall, Michael. / Caesarean section delivery and the risk of allergic disorders in childhood. In: Clinical and Experimental Allergy. 2005 ; Vol. 35, No. 11. pp. 1466-1472.
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abstract = "Background: The composition of the intestinal flora in young children, if unfavourable, may increase the susceptibility to allergic disorders. Beneficial intestinal microbes originate from the maternal vaginal tract and thus are more likely to be transferred during vaginal births than during Caesarean sections (C-sections). Objective: To determine whether children born by C-section have a different risk of allergic disorders compared with those delivered vaginally. We also tested the hypothesis that the risk of allergic disorders is highest for children born after 'repeat C-sections'. Methods: A retrospective cohort study of 8953 children aged 3-10 years. Children diagnosed with allergic rhinoconjunctivitis (AR), asthma, atopic dermatitis (AD), or food allergies were identified from the Kaiser Permanente Northwest Region electronic records. The children's sex, birth weight, birth order, postnatal exposure to antibiotics as well as the mothers' age, ethnicity, education, marital status, smoking status during pregnancy, and use of asthma or hayfever medications were identified through the mothers' medical records or through the Oregon Birth Registry. Results: The risk of being diagnosed with AR was significantly higher in the children born by C-section than in those delivered vaginally: adjusted odds ratio (OR)=1.37{\%}, 95{\%} confidence interval (CI)=1.14-1.63. Delivery by C-section was also associated with the subsequent diagnosis of asthma (OR=1.24{\%}, 95{\%} CI=1.01-1.53); this association was gender specific, with a positive association restricted to girls (OR for asthma in girls: OR=1.53{\%}, 95{\%} CI=1.11-2.10; in boys: OR=1.08{\%}, 95{\%} CI=0.81-1.43). There was no significant association between mode of delivery and AD. If children born in a 'repeat C-section' were considered separately the risk of being diagnosed with AR increased further (OR=1.78{\%}, 95{\%} CI=1.34-2.37). The same increase was noted for asthma in girls (OR=1.83{\%}, 95{\%} CI=1.13-2.97) but not in boys. Conclusion: Caesarean sections may be associated with an increased risk of developing AR in childhood.",
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AU - David, M. R.

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AU - O'Connor, E. A.

AU - Frazier, E. A.

AU - Wall, Michael

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N2 - Background: The composition of the intestinal flora in young children, if unfavourable, may increase the susceptibility to allergic disorders. Beneficial intestinal microbes originate from the maternal vaginal tract and thus are more likely to be transferred during vaginal births than during Caesarean sections (C-sections). Objective: To determine whether children born by C-section have a different risk of allergic disorders compared with those delivered vaginally. We also tested the hypothesis that the risk of allergic disorders is highest for children born after 'repeat C-sections'. Methods: A retrospective cohort study of 8953 children aged 3-10 years. Children diagnosed with allergic rhinoconjunctivitis (AR), asthma, atopic dermatitis (AD), or food allergies were identified from the Kaiser Permanente Northwest Region electronic records. The children's sex, birth weight, birth order, postnatal exposure to antibiotics as well as the mothers' age, ethnicity, education, marital status, smoking status during pregnancy, and use of asthma or hayfever medications were identified through the mothers' medical records or through the Oregon Birth Registry. Results: The risk of being diagnosed with AR was significantly higher in the children born by C-section than in those delivered vaginally: adjusted odds ratio (OR)=1.37%, 95% confidence interval (CI)=1.14-1.63. Delivery by C-section was also associated with the subsequent diagnosis of asthma (OR=1.24%, 95% CI=1.01-1.53); this association was gender specific, with a positive association restricted to girls (OR for asthma in girls: OR=1.53%, 95% CI=1.11-2.10; in boys: OR=1.08%, 95% CI=0.81-1.43). There was no significant association between mode of delivery and AD. If children born in a 'repeat C-section' were considered separately the risk of being diagnosed with AR increased further (OR=1.78%, 95% CI=1.34-2.37). The same increase was noted for asthma in girls (OR=1.83%, 95% CI=1.13-2.97) but not in boys. Conclusion: Caesarean sections may be associated with an increased risk of developing AR in childhood.

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