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Sex Differences in Wheezing During the First Three Years of Life After Delivery via Caesarean Section

Evangelia Papathoma1, Theodore Dassios1, Maria Triga1

  • 1Department of Paediatrics, University of Patras, GR26504 Patras, Greece.

Children (Basel, Switzerland)
|August 28, 2025
PubMed

Insights

Caesarean birth increases preschool wheezing risk in girls, but not in boys. Male sex is an overall risk factor for childhood wheezing, irrespective of delivery method.

Area of Science:

  • Pediatrics
  • Obstetrics
  • Epidemiology

Background:

  • Caesarean section delivery is linked to childhood wheezing.
  • Sex-specific differences in this association require further investigation.
  • Perinatal and antenatal confounders are crucial considerations.

Purpose of the Study:

  • To investigate sex-specific differences in the association between caesarean section delivery and preschool wheezing.
  • To explore the impact of delivery mode on wheezing development in relation to child's sex.
  • To adjust for potential confounding factors in the analysis.

Main Methods:

  • Secondary analysis of 470 children followed until 36 months.
  • Wheezing defined as annual doctor-diagnosed episodes over three years.
  • Multivariable regression models used to analyze associations and adjust for confounders.

Main Results:

  • Caesarean section rate was 51%; 31% of children experienced wheezing.
  • Girls born via caesarean section had a significantly higher risk of wheezing (OR: 2.48, p=0.007).
  • Male sex was associated with increased wheezing risk overall (OR: 1.83, p=0.004), but caesarean section did not significantly increase risk in boys.

Conclusions:

  • Girls born by caesarean section exhibit a higher frequency of wheezing in early childhood.
  • While male sex is an independent risk factor for preschool wheezing, caesarean section delivery does not further elevate this risk in boys.
  • Findings highlight the importance of considering sex in the relationship between birth mode and respiratory outcomes.
Abstract

Keywords:
caesarean sectionchildrenwheezing

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