Annemaria C van Berkel1,2,3, Herman T den Dekker1,2,3, Vincent W V Jaddoe1,3,4, Irwin K Reiss5, Romy Gaillard1,3, Albert Hofman3, Johan C de Jongste2, Liesbeth Duijts2,3,5. 1. The Generation R Study Group, Erasmus Medical Center, Rotterdam, The Netherlands. 2. Division of Respiratory Medicine, Department of Paediatrics, Erasmus Medical Center, Rotterdam, The Netherlands. 3. Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands. 4. Department of Paediatrics, Erasmus Medical Center, Rotterdam, The Netherlands. 5. Division of Neonatology, Department of Paediatrics, Erasmus Medical Center, Rotterdam, The Netherlands.
Abstract
BACKGROUND: Previous studies suggest that caesarean section may influence the risk of childhood asthma. We examined the associations of different modes of delivery with childhood wheezing patterns, asthma, fractional exhaled nitric oxide (FeNO) and airway interrupter resistance (Rint) up to school age. METHODS: This study among 6,128 children was embedded in a population-based prospective cohort study. Information on mode of delivery was obtained from midwives and hospital registries. Wheezing patterns from birth onwards and ever physician-diagnosed asthma at age 6 yr were assessed by questionnaires. FeNO and Rint were measured at age 6 yr. We used multivariate polynomial, logistic and linear regression models. RESULTS: Compared with vaginal delivery, caesarean section was associated with increased risks of early and persistent wheezing up to school age [odds ratios (95% confidence interval): 1.36 (1.06, 1.75) and 1.73 (1.24, 2.40), respectively]. The effect sizes of elective and emergency caesarean section with wheezing outcomes were similar. Only elective caesarean section was associated with a higher FeNO level [sympercent (95% CI): 12.7 (0.6, 24.8)]. We did not observe associations of mode of delivery with asthma or Rint. Also, vacuum- or forceps-assisted vaginal delivery was not associated with any asthma or related outcome. CONCLUSIONS: Both elective and emergency caesarean sections are associated with increased risks of early and persistent wheezing up to school age. This might be explained by increased airway inflammation reflected by higher FeNO levels.
BACKGROUND: Previous studies suggest that caesarean section may influence the risk of childhood asthma. We examined the associations of different modes of delivery with childhood wheezing patterns, asthma, fractional exhaled nitric oxide (FeNO) and airway interrupter resistance (Rint) up to school age. METHODS: This study among 6,128 children was embedded in a population-based prospective cohort study. Information on mode of delivery was obtained from midwives and hospital registries. Wheezing patterns from birth onwards and ever physician-diagnosed asthma at age 6 yr were assessed by questionnaires. FeNO and Rint were measured at age 6 yr. We used multivariate polynomial, logistic and linear regression models. RESULTS: Compared with vaginal delivery, caesarean section was associated with increased risks of early and persistent wheezing up to school age [odds ratios (95% confidence interval): 1.36 (1.06, 1.75) and 1.73 (1.24, 2.40), respectively]. The effect sizes of elective and emergency caesarean section with wheezing outcomes were similar. Only elective caesarean section was associated with a higher FeNO level [sympercent (95% CI): 12.7 (0.6, 24.8)]. We did not observe associations of mode of delivery with asthma or Rint. Also, vacuum- or forceps-assisted vaginal delivery was not associated with any asthma or related outcome. CONCLUSIONS: Both elective and emergency caesarean sections are associated with increased risks of early and persistent wheezing up to school age. This might be explained by increased airway inflammation reflected by higher FeNO levels.
Authors: Azahara María García-Serna; Elena Martín-Orozco; Trinidad Hernández-Caselles; Eva Morales Journal: Int J Environ Res Public Health Date: 2021-04-09 Impact factor: 3.390
Authors: Andressa Daronco Cereta; Vinícius Rosa Oliveira; Ivan Peres Costa; Letícia Lopes Guimarães; João Pedro Ribeiro Afonso; Adriano Luís Fonseca; Alan Robson Trigueiro de Sousa; Guilherme Augusto Moreira Silva; Diego A C P G Mello; Luis Vicente Franco de Oliveira; Renata Kelly da Palma Journal: Front Med (Lausanne) Date: 2021-06-16
Authors: Aneta Słabuszewska-Jóźwiak; Jacek Krzysztof Szymański; Michał Ciebiera; Beata Sarecka-Hujar; Grzegorz Jakiel Journal: Int J Environ Res Public Health Date: 2020-10-31 Impact factor: 3.390