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Caesarean delivery and risk of childhood asthma development: meta-analysis
Agata Wypych-Ślusarska1, Ewa Niewiadomska1, Klaudia Oleksiuk1
1Department of Epidemiology and Biostatistics, School of Health Sciences in Bytom, Medical University of Silesia in Katowice, Poland.
Insights
Caesarean delivery may increase the risk of childhood asthma, particularly when diagnosed via parental questionnaires. However, overall study heterogeneity prevents a definitive conclusion on caesarean birth as a causal factor for asthma development.
Area of Science:
- Pediatrics
- Epidemiology
- Respiratory Medicine
Background:
- Childhood asthma is a significant public health concern.
- Caesarean section delivery has been suggested as a potential risk factor for asthma development in children.
Purpose of the Study:
- To conduct a meta-analysis to determine the association between caesarean delivery and childhood asthma.
- To evaluate the risk of asthma development in children born via caesarean section.
Main Methods:
- A systematic review of bibliographic databases identified 41 articles, with 12 included in the meta-analysis.
- Odds ratios (OR) were analyzed, considering unadjusted OR and calculating them from reported prevalence.
- Heterogeneity was assessed using the chi-squared test (p < 0.05 significance level).
Main Results:
- Caesarean delivery was associated with an increased risk of childhood asthma (OR = 1.41), though significant heterogeneity was observed.
- A homogeneous and significantly higher risk of asthma was found in children born by caesarean section when asthma was confirmed via questionnaire (OR = 1.26).
Conclusions:
- Parent-reported asthma diagnoses in questionnaire-based studies showed a significantly higher risk in children born via caesarean section.
- Due to substantial heterogeneity across studies, a definitive causal link between caesarean delivery and bronchial asthma cannot be established.
Introduction:
Several studies indicate that delivery by caesarean section may be one of the risk factors for the development of childhood asthma.
Aim:
A meta-analysis was carried out to establish the relationship between delivery by caesarean section and asthma in children.
Material And Methods:
After a review of bibliographic databases, 41 articles were obtained and 12 of which were accepted for further analysis. The odds ratios (OR) included in the analysis were specified on the basis of data from the presented studies or were calculated using reported prevalence. The analysis took into account unadjusted OR. The heterogeneity of results was assessed using the χ2 test, determining p < 0.05 as the level of significance. The analysis was performed using Statistica 13.3 and kit 4.0.67.
Results:
Caesarean delivery was associated with an increased risk of development of childhood asthma (OR = 1.41); however, significant heterogeneity of results was demonstrated. A significantly higher risk of asthma was found in children born by caesarean section in the case where the disease was confirmed in a questionnaire-based study (OR = 1.26, 95% CI: 1.05-1.5), and the results of that study were homogeneous.
Conclusions:
In the case of the diagnosis of asthma declared by parents in the questionnaire-based study, a significantly higher risk of disease occurrence was observed in children born by caesarean section. Due to the significant heterogeneity of the results of the studies, it cannot be clearly stated that caesarean delivery is a risk factor for the development of bronchial asthma.
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