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Short-term and long-term effects of cesarean section on asthma and wheezing: A cohort study and meta-analysis

Yuxiu Liang1, Jiatao Zhang1, Shuoxin Bai2

  • 1Department of Occupational and Environmental Health, School of Public Health, Cheeloo College of Medicine, Shandong University, 44 Wenhua Xi Road, Jinan, Shandong, 250012, PR China.

Respiratory Medicine
|May 31, 2023
PubMed

Insights

Cesarean section is linked to increased risks of childhood asthma and wheezing, with effects persisting long-term. This study confirms both short-term and lasting impacts on respiratory health in children.

Area of Science:

  • Pediatric Respiratory Medicine
  • Obstetrics and Gynecology
  • Epidemiology

Background:

  • Cesarean section (CS) is a common delivery method with potential long-term health implications for offspring.
  • Childhood asthma and wheezing are significant public health concerns, and their etiology is multifactorial.
  • Understanding the relationship between CS and respiratory outcomes is crucial for preventative strategies.

Approach:

  • A cohort study followed 6501 children from birth to age 2, analyzing the association between CS and respiratory diseases using logistic regression.
  • A meta-analysis was conducted, combining data from the cohort study with existing literature to assess short-term (under 2 years) and long-term (over 2 years) effects of CS on childhood asthma and wheezing.
  • Statistical models, including logistic regression and meta-analysis with I-squared (I² ) for heterogeneity, were employed to estimate odds ratios (OR) and confidence intervals (CI).

Key Points:

  • The cohort study found a cumulative incidence of asthma and wheezing of 1.3% among 6501 children, with 45.5% born via CS.
  • A meta-analysis combining studies showed a short-term effect of CS on asthma and wheezing under age 2 (OR = 1.15, 95% CI: 1.05-1.25).
  • Cesarean section demonstrated a significant long-term effect on asthma and wheezing in children over age 2 (OR = 1.17, 95% CI: 1.11-1.24).

Conclusions:

  • Cesarean section is associated with an increased risk of asthma and wheezing in children, with effects observed both before and after the age of 2.
  • The study highlights a persistent link between cesarean delivery and adverse respiratory outcomes throughout childhood.
  • These findings underscore the importance of considering delivery mode in the context of pediatric respiratory health and potential long-term consequences.
Abstract

Keywords:
AsthmaCesarean sectionChildCohort studyMeta-analysisWheezing

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