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Published on: March 12, 2020
Caesarean section and asthma in Malaysian children: a case-control study
Anna Marie Nathan1, Jessie de Bruyne, Farah Khalid
1Department of Paediatrics, University Malaya Medical Centre, Kuala Lumpur, Malaysia. psr9900@hotmail.com
Insights
Caesarean section delivery was not linked to childhood asthma in Malaysian children. A family history of atopy and early introduction of solid foods were significant factors influencing asthma development.
Area of Science:
- Pediatric Allergy and Immunology
- Epidemiology
- Obstetrics and Gynecology
Background:
- Previous studies suggest a correlation between caesarean section birth and increased asthma risk.
- Understanding this association is crucial for public health initiatives and early intervention strategies.
Purpose of the Study:
- To investigate the association between caesarean section delivery and the development of asthma in Malaysian children.
- To identify other potential risk and protective factors for childhood asthma in this population.
Main Methods:
- A case-control study was conducted with 156 Malaysian children (aged 3-15 years).
- Seventy-eight children diagnosed with asthma (cases) were matched with 78 children without asthma (controls).
- Data on delivery mode, family history of allergies, total serum IgE levels, and skin prick test results were collected.
Main Results:
- No significant association was found between caesarean section delivery and childhood asthma (OR = 1.21, p = 0.596).
- Children born via caesarean section did not exhibit higher IgE levels or increased aeroallergen sensitization.
- A positive family history of atopy strongly predicted asthma (OR = 13.8, p < 0.001), while introducing semi-solid foods after 6 months showed a protective effect (OR = 0.97, p = 0.034).
Conclusions:
- In Malaysian children, delivery by caesarean section is not a significant risk factor for developing asthma.
- Family history of atopy and infant feeding practices are more critical determinants of childhood asthma.
Background:
Birth cohort studies in some countries have shown a link between caesarean section and asthma.
Aim:
To determine if there is an association between asthma and delivery via caesarean section in Malaysian children.
Method:
This is a case-control study involving 156 children aged 3-15 years old, in a tertiary hospital in Kuala Lumpur, Malaysia. Seventy-eight children with a confirmed diagnosis of asthma and seventy-eight age-matched controls (no history of asthma or wheezing) were enrolled. Demographic data including mode of delivery and family history of allergic disorders was obtained. Total serum immunoglobulin E (IgE) was measured and skin prick tests (SPT) to 6 common aeroallergens were performed.
Results:
The median age of the patients was 8 years old. One hundred and three (66%) children were delivered via normal vaginal delivery, 8 (5.1%) via assisted vaginal delivery and 45 children (28.9%) via caesarean section. Delivery via caesarean section was not significantly associated with asthma (OR = 1.21 [95% CI 0.60-2.41], p = 0.596). Children delivered via caesarean section did not have higher IgE levels nor were they more sensitized to aeroallergens. Multiple logistic regression showed that asthma was significantly associated with a positive family history of atopy (OR = 13.8 [95% CI 5.96, 32.1], p < 0.001). Introduction of semi-solid food after 6 months old had a protective effect against asthma (OR = 0.97 [95% CI 0.94, 0.99], p = 0.034).
Conclusion:
Childhood asthma in Malaysian children was not associated with delivery by caesarean section.
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Asthma-III: Symptoms and Complications
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