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Published on: June 6, 2020
Association between Cesarean section delivery and increased risk of childhood Kawasaki disease
Chih-Fu Wei1, Mei-Huei Chen2, Ching-Chun Lin3
1Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
Insights
Cesarean section delivery may increase the risk of Kawasaki disease in infants. This study found a higher risk of Kawasaki disease in children born via Cesarean section.
Area of Science:
- Pediatrics
- Immunology
- Epidemiology
Background:
- Cesarean section delivery is linked to childhood microbiota disruption and immune dysregulation.
- The association between Cesarean section and Kawasaki disease risk is not well-established.
Purpose of the Study:
- To investigate the potential association between Cesarean section delivery and the incidence of Kawasaki disease.
Main Methods:
- A birth cohort of 15,796 mother-infant pairs in Taiwan was analyzed.
- Poisson regression and propensity score matching were used to assess associations.
- Febrile convulsion, trauma, and accidents served as negative control outcomes.
Main Results:
- Cesarean section delivery was associated with an increased risk of Kawasaki disease (aRR: 2.22, 95% CI: 1.14-4.34).
- This association persisted in the propensity score-matched subpopulation (aRR: 2.29, 95% CI: 1.14-4.68).
- No association was found between Cesarean section and control outcomes.
Conclusions:
- Cesarean section delivery may be associated with a higher risk of Kawasaki disease in infants aged six to eighteen months.
- The findings suggest a potential link between birth mode and Kawasaki disease development.
Aim:
Cesarean section delivery is associated with microbiota disruption and immuno-dysregulation during childhood, but the association with Kawasaki disease remains uncertain. We aimed to evaluate the association between Cesarean section and Kawasaki disease.
Methods:
We examined the association between Kawasaki disease between six and eighteen months and Cesarean section within a birth cohort of 15,796 mother-infant pairs in Taiwan. The associations were assessed with Poisson regression in the study population, in the 1:2 propensity score-matched subpopulation, and compared with febrile convulsion, trauma and accidents during the same interval as negative control outcomes.
Results:
Cesarean section was found to increase the risk of Kawasaki disease among overall population (adjusted relative risk [aRR]: 2.22, 95 % confidence interval (CI): 1.14-4.34) and the matched subpopulation (aRR: 2.29, 95 % CI: 1.14-4.68 in PS-matched subpopulation). Meanwhile, there was no association between Cesarean section and the clinic visits for febrile convulsion, trauma and accidents.
Conclusion:
In conclusion, this study identified a potential association between Cesarean section delivery and a higher risk of Kawasaki disease during six-to eighteen months of the prospective birth cohort in Taiwan.
