Are children born by cesarean section at higher risk for respiratory sequelae?

Salem, Yasmin; Oestreich, Marc-Alexander Heinz; Fuchs, Oliver; Usemann, Jakob; Frey, Urs; Surbek, Daniel; Amylidi-Mohr, Sofia; Latzin, Philipp; Ramsey, Kathryn A.; Yammine, Sophie (2022). Are children born by cesarean section at higher risk for respiratory sequelae? American journal of obstetrics and gynecology, 226(2), 257.e1-257.e11. Elsevier 10.1016/j.ajog.2021.07.027

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BACKGROUND

Globally, the number of children born by cesarean section (CS) is constantly increasing. However, hormonal and physiological changes associated with labor and vaginal delivery (VD) are considered necessary for lung maturation.

OBJECTIVE

We aimed to assess if the mode of delivery is associated with changes in respiratory and atopic outcomes in infancy and at school-age.

STUDY DESIGN

We included 578 children born ≥37 weeks of gestational age from a prospective birth cohort study. We compared weekly respiratory symptoms throughout the first year of life, and infant lung function (tidal breathing, multiple-breath washout (MBW)) at five weeks between children born by CS (N=114) and VD (N=464) after term pregnancy in healthy women. For follow-up at six years (N=371, of which 65 CS) we assessed respiratory, atopic, and lung function outcomes (spirometry, body plethysmography, MBW). We performed adjusted regression analyses to examine the association between CS, respiratory, and atopic outcomes. To account for multiple testing, we used bonferroni correction resulting in an adapted significance level at P<0.002.

RESULTS

In infancy, children born by CS did not have more respiratory symptoms compared to VD (median (IQR) weeks with respiratory symptoms 4 (7) versus 5 (7); adjusted incidence rate ratio 0.8 (95% CI 0.6 to 1.0, P=0.02). Infant lung function was similar between groups. Children born by CS did not have more "ever wheezing" (adjusted Odds ratio 0.9 (95% CI 0.5 to 1.8, P=0.78)) or current asthma (0.4 (0.0 to 3.5, P=0.42)) at school-age compared to VD. Lung function parameters were not different between groups.

CONCLUSION

CS was not associated with respiratory symptoms in the first year of life, nor with different respiratory or atopic outcomes at school-age compared to VD. Our results indicate that there are no long-term consequences of CS on the respiratory health of the child.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Gynaecology, Paediatrics and Endocrinology (DFKE) > Clinic of Paediatric Medicine
04 Faculty of Medicine > Department of Gynaecology, Paediatrics and Endocrinology (DFKE) > Clinic of Gynaecology
04 Faculty of Medicine > Pre-clinic Human Medicine > BioMedical Research (DBMR) > Unit Childrens Hospital > Forschungsgruppe Pneumologie (Pädiatrie)
04 Faculty of Medicine > Department of Gynaecology, Paediatrics and Endocrinology (DFKE) > Clinic of Paediatric Medicine > Paediatric Pneumology

Graduate School:

Graduate School for Health Sciences (GHS)

UniBE Contributor:

Salem, Yasmin; Oestreich, Marc-Alexander Heinz; Fuchs, Oliver; Usemann, Jakob; Surbek, Daniel; Amylidi, Sofia Kalypso; Latzin, Philipp; Ramsey, Kathryn Angela and Yammine, Sophie

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0002-9378

Publisher:

Elsevier

Language:

English

Submitter:

Anette van Dorland

Date Deposited:

16 Sep 2021 10:55

Last Modified:

05 Dec 2022 15:53

Publisher DOI:

10.1016/j.ajog.2021.07.027

PubMed ID:

34364843

BORIS DOI:

10.48350/159012

URI:

https://boris.unibe.ch/id/eprint/159012

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