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Cesarean section and risk of allergies in Ecuadorian children: A cross-sectional study
Amélie Gorris1,2,3, Gabriela Bustamante1,4, Katharina A Mayer2
1School of Medicine, Universidad San Francisco de Quito, Quito, Ecuador.
Insights
Cesarean section (CS) delivery is linked to a higher risk of childhood allergies like asthma and dermatitis, even in developing countries. This study confirms the association in Ecuador, highlighting the need for further research into prevention strategies.
Area of Science:
- Pediatric Allergy and Immunology
- Epidemiology
- Obstetrics and Gynecology
Background:
- Established link between cesarean section (CS) and increased childhood allergic diseases in industrialized nations.
- Limited evidence from developing countries regarding the association between delivery mode and allergic outcomes.
Purpose of the Study:
- To investigate the association between delivery mode (CS vs. vaginal) and allergic diseases in children aged 3-12 years in Quito, Ecuador.
- To assess the risk of conditions such as asthma, allergic rhinitis, atopic dermatitis, and food allergies based on birth method.
Main Methods:
- Cross-sectional study utilizing anonymous, standardized questionnaires from the International Study of Asthma and Allergies in Childhood project.
- Data collected on children's allergic conditions, delivery mode, age, sex, socioeconomic status, ethnicity, gestational age, breastfeeding, and parental history of allergies.
- Statistical analysis adjusted for potential confounding factors.
Main Results:
- Cesarean section delivery was associated with a significantly higher risk of wheezing (OR=4.12), physician-diagnosed asthma (OR=24.06), and atopic dermatitis/eczema (OR=2.65) compared to vaginal delivery.
- No significant association was found between CS and allergic rhinitis or food allergies.
- The association between CS and allergic disorders was primarily observed in children from medium/high socioeconomic backgrounds.
Conclusions:
- Cesarean section delivery increases the risk of allergic disorders, including asthma and dermatitis, in children in non-industrialized settings, mirroring findings from industrialized countries.
- The study underscores the importance of considering delivery mode as a risk factor for allergic diseases in diverse global populations.
Background:
Studies have shown an association between cesarean section (CS) and increased prevalence of childhood allergic diseases. While these observations have been consistent in industrialized countries, evidence from developing countries is limited.
Objective:
To assess the association between the mode of delivery and allergic diseases in children aged 3-12 years in Quito, Ecuador.
Methods:
In this cross-sectional study, parents were surveyed using an anonymous, standardized questionnaire from the International Study of Asthma and Allergies in Childhood project to assess the presence of asthma, allergic rhinitis, atopic dermatitis, and food allergies in their children. The children's age, sex, birthplace, delivery mode (CS/vaginal), socioeconomic status, and ethnicity were recorded. Other parameters included gestational age, breastfeeding, smoking status during pregnancy, and parental allergic diseases.
Results:
After adjusting for confounding factors, children delivered via CS were found to have a higher risk of wheezing (odds ratio [OR] = 4.12, 95% confidence interval [CI]: 1.43-11.89), physician-diagnosed asthma (OR = 24.06; 95% CI: 1.98-292.3), and pimples, or eczema with the itching for 6 months (OR = 2.65; 95% CI: 1.06-6.61) than children delivered vaginally. No association was found between the delivery mode and rhinitis or food allergies. After stratifying by socioeconomic status, CS was only associated with allergic disorders in children of medium/high socioeconomic backgrounds.
Conclusions:
As seen in industrialized settings, children born by CS in nonindustrialized countries have an increased risk of developing allergic disorders including asthma and dermatitis, compared to those delivered vaginally.
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