Cesarean section without medical indication and risks of childhood allergic disorder, attenuated by breastfeeding

Area of Science:

• Pediatrics
• Allergology
• Epidemiology

Background:

• Caesarean section (CS) delivery is a common birth method.
• Previous research suggests a link between CS and increased risk of childhood asthma and allergic diseases.
• Confounding factors, such as medical indications for CS, have limited the interpretation of prior studies.

Purpose of the Study:

• To investigate the association between CS delivery itself, independent of medical indications, and the risks of childhood asthma and allergic rhinitis.
• To explore the potential modifying effect of infant feeding practices on the relationship between CS and allergic diseases.

Main Methods:

• Utilized data from the 2014 Shanghai Children's Health, Education and Lifestyle Evaluation, a large population-based survey.
• Included 12,639 children, analyzing mode of delivery and parental-reported history of asthma and allergic rhinitis.
• Employed cluster random probability sampling across 26 primary schools in Shanghai, China.

Main Results:

• CS delivery without medical indication was significantly associated with an increased risk of childhood asthma.
• CS delivery (both without indication and for fetal complications) was linked to higher risks of childhood allergic rhinitis.
• The association between CS and these conditions was significantly attenuated in infants exclusively or mixed-fed breast milk in the first four months, but pronounced in formula-fed infants.

Conclusions:

• CS delivery, even when not medically indicated, increases the risk of childhood asthma and allergic rhinitis.
• Early infant feeding, particularly exclusive breastfeeding, may mitigate the adverse effects of CS on the development of allergic diseases.
• Findings highlight the importance of considering both mode of delivery and infant feeding practices in managing childhood respiratory and allergic conditions.