Related Experiment Video
Updated: Dec 21, 2025
Noninvasive Sampling of Mucosal Lining Fluid for the Quantification of In Vivo Upper Airway Immune-mediator Levels
Published on: August 7, 2017
Cesarean delivery and the risk of allergic rhinitis in children
Megan Richards1, Jeannette Ferber2, De-Kun Li2
1School of Community Health Sciences, University of Nevada, Reno, Nevada.
Insights
Cesarean delivery (C-section) did not show an association with allergic rhinitis (AR) in children up to age 10. This large study found no increased risk of AR for infants born via C-section, even after adjusting for key factors.
Area of Science:
- Pediatric Health
- Immunology
- Epidemiology
Background:
- Cesarean delivery (C-section) may impact infant gut microbiome and immune development.
- Potential links between C-section and increased risk of allergic rhinitis (AR) have been suggested.
- Understanding this association is crucial for pediatric health outcomes.
Purpose of the Study:
- To investigate the relationship between C-section and the incidence of allergic rhinitis (AR).
- To assess this association at multiple childhood follow-up ages: 6, 8, and 10 years.
- To provide robust data on C-section's long-term effects on AR risk.
Main Methods:
- Prospective data collection from a large US integrated healthcare system (n > 100,000 at age 6).
- Risk ratios (RR) for C-section and AR were calculated at ages 6, 8, and 10.
- Adjustments were made for confounders like antibiotics, maternal BMI, and breastfeeding.
Main Results:
- No significant association was found between C-section and AR at ages 6, 8, or 10 years.
- Adjusted RRs for AR were consistently near 1.0 across all follow-up ages.
- Subgroup analyses showed limited evidence of increased AR risk in specific populations, but overall findings indicated no link.
Conclusions:
- Cesarean delivery is not associated with an increased risk of allergic rhinitis in children.
- Findings from this large cohort suggest C-section does not negatively impact long-term AR development.
- This study contributes significant evidence regarding the safety of C-section concerning allergic disease.
Background:
Cesarean delivery (C-section) may influence the infant microbiome and affect immune system development and subsequent risk for allergic rhinitis (AR).
Objective:
To investigate the association between C-section and AR at ages 6, 8, and 10 years.
Methods:
Data were collected prospectively through Kaiser Permanente Northern Californias (KPNC) integrated healthcare system. Children were eligible if they were born in a KPNC hospital and remained in the KPNC system for minimum 6 years (n = 117,768 age 6; n = 75,115 age 8; n = 40,332 age 10). Risk ratios (RR) for C-section and AR were estimated at each follow-up age and adjusted for important covariates, including intrapartum antibiotics, pre-pregnancy body mass index, maternal allergic morbidities, and breastfeeding. Subanalyses considered information on C-section indication, labor, and membrane rupture.
Results:
After adjusting for confounders, we did not observe an association between C-section and AR at follow-up ages 6, 8, or 10 years (RR [CI]: 6 years, 0.98 [0.91, 1.04]; 8 years, 1.00 [0.95, 1.07]; 10 years, 1.03 [0.96, 1.10]). In stratified analyses, there was limited evidence that C-section increases the risk of AR in certain subgroups (eg, children of non-atopic mothers, second or higher birth order children), but most estimated risk ratios were consistent with no association. Estimated associations were unaffected by participant attrition, missing data, or intrapartum antibiotics.
Conclusion:
C-section delivery was not associated with AR at follow-up ages of 6, 8, or 10 years in a large contemporary US cohort.
Related Concept Videos
01:19Rh Blood Group
02:06Allergic Reactions
01:29Asthma-I: Introduction
01:23Upper Respiratory Drugs: Antitussives, Expectorants, and Mucolytics
Antitussives include codeine, dextromethorphan (Robitussin), and benzonatate (Tessalon). Codeine and dextromethorphan exert their effects centrally by suppressing the cough reflex center in the medulla. Benzonatate operates peripherally within the respiratory tract by...
01:27Allergic Drug Reactions
01:20Asthma: Pathogenesis and Management
Asthma is classified as allergic and non-allergic. Allergens such as dust mites, pollen, and pet dander trigger allergic asthma, while factors like cold air, intense emotions, or exercise can induce non-allergic asthma.