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Cesarean delivery is associated with celiac disease but not inflammatory bowel disease in children
Evalotte Decker1, Guido Engelmann, Annette Findeisen
1Department of Pediatrics, Institute for Medical Microbiology and Hospital Epidemiology, Hannover Medical School, Hannover, Germany.
Insights
Cesarean delivery may increase the risk of celiac disease in children. This study found a higher likelihood of cesarean birth among children diagnosed with celiac disease compared to controls.
Area of Science:
- Pediatric Gastroenterology
- Epidemiology
- Neonatal Health
Background:
- Cesarean delivery is a common birth method with potential long-term health implications.
- Enteric inflammatory diseases in children represent a significant public health concern.
Purpose of the Study:
- To investigate the association between cesarean delivery and the development of pediatric enteric inflammatory diseases.
- To determine if mode of delivery influences the risk of specific gastrointestinal conditions in children.
Main Methods:
- A multicenter, retrospective case-control study involving 1950 children across 42 hospitals.
- Data collected included mode of delivery, gestational age, and medical history for children with Crohn disease, ulcerative colitis, celiac disease, and controls.
Main Results:
- Children with celiac disease showed a significantly higher rate of cesarean delivery compared to control subjects (OR: 1.8, 95% CI: 1.13-2.88).
- No significant association was observed between cesarean delivery and Crohn disease or ulcerative colitis.
Conclusions:
- Mode of delivery may play a role in the development of celiac disease.
- Neonatal enteric homeostasis alterations linked to delivery mode could impact celiac disease incidence.
Objectives:
The aim of this study was to analyze a possible association between cesarean delivery and enteric inflammatory diseases in children.
Methods:
A retrospective, multicenter, case-control study that included 1950 children was performed in cooperation with 26 university and 16 nonacademic children's hospitals. Information on intestinal disease manifestation, together with mode of delivery and gestational age at birth, postnatal complications, and breastfeeding, was collected by the attending physician from children and their parents who were visiting a gastrointestinal outpatient clinic for Crohn disease (CD; 516 cases), ulcerative colitis (250 cases), celiac disease (157 cases), and other gastrointestinal diseases (165 cases) and control subjects who were visiting ophthalmologic, orthodontic, and dental outpatient clinics (862 cases).
Results:
Whereas the rate of cesarean delivery of children with Crohn disease or ulcerative colitis was similar to that of control subjects, a significantly enhanced likelihood of being born by cesarean delivery was found in children with celiac disease compared with control subjects (odds ratio: 1.8 [95% confidence interval: 1.13-2.88]; P = .014).
Conclusions:
The mode of delivery and associated alterations in the development of the enteric homeostasis during the neonatal period might influence the incidence of celiac disease.
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