Published Online: September 11, 2015
Earlier studies have reported an increased risk of diseases associated with immune function in children born by caesarean section (CS), but most studies have not discriminated between the effects of acute and elective CS.
In a study recently published in The Journal of Allergy and Clinical Immunology (JACI), Kristensen and Henriksen analyzed the association between birth by acute and elective caesarean section (CS) and the risk of diseases associated with immune function in a cohort of 750,569 children aged 0 – 14 years. The authors found that children delivered by both acute and elective CS had an increased risk of asthma, laryngitis, and gastrointestinal infection. Children delivered by acute CS had an increased risk of ulcerous colitis and celiac disease, whereas children delivered by elective CS had an increased risk of lower respiratory tract infection and juvenile idiopathic arthritis. Regarding the risk of asthma, the effect of elective CS was higher than the effect of acute CS.
The authors conclude that delivery by CS is associated with an increased risk of diseases related to immune function. The effect is mainly on diseases involving the mucosal immune system. They suggest that their findings may partly be explained by the aberrant gut flora found in children delivered by CS, and this is supported by their finding of a higher risk of asthma after elective than after acute CS. Thus, in elective CS the membranes are usually intact and therefore the child has not been exposed to the mother`s vaginal microflora, which is in contrast to acute CS, where the membranes are usually ruptured and the child therefore may be colonized already in utero.
The Journal of Allergy and Clinical Immunology (JACI) is an official scientific journal of the AAAAI, and is the most-cited journal in the field of allergy and clinical immunology.