Cesarean delivery increases risks of asthma and allergies in offspring
Published online June 20, 2024
Cesarean section has gained widespread acceptance, and cesarean rates are on the rise. Offspring delivered by cesarean section are prone to multiple conditions, including obesity, mental disorders, type 1 diabetes, and acute lymphoblastic leukemia. However, population-based studies investigating the effects of cesarean section on the incidence of allergic diseases in offspring have yielded inconsistent results.
This study from Liu et al., recently published in The Journal of Allergy and Clinical Immunology: In Practice, reported the findings of a systematic literature review for the association between cesarean delivery and the risk of allergic diseases in offspring. Data were extracted from comparative studies published in three core databases, including PubMed, Embase, and the Cochrane Library, from their inception to October 12, 2023.
A total of 113 comparative studies were included in the systematic review, 70 of which had a low risk of bias. The most adjusted estimates revealed that cesarean delivery was associated with increased risks of multiple allergic diseases in offspring. The risk was most pronounced for food allergies (35% higher risk, n=1,174,077), followed by asthma (20% higher risk, n=9,690,452), allergic sensitization (19% higher risk, n=28,761), and allergic rhinitis or conjunctivitis (15% higher risk, n=2,163,987). There was also a small but significant increase in the risk of atopic dermatitis or eczema (8% higher risk, n=3,164,885). Subgroup analyses suggested that offspring aged ≤ 6 years, offspring in populations with a cesarean section rate > 15%, offspring in high-latitude regions, and offspring in developing countries were associated with increased allergic risk after cesarean section delivery. The impact of cesarean delivery on urticaria and purpura in offspring remains uncertain.
These findings enhance our understanding of the adverse outcomes associated with cesarean delivery, highlighting the necessity of reducing unnecessary cesarean sections. This study provides detailed information on the risk of allergic diseases in offspring and personalized risk estimates for mothers with low-risk pregnancies, enabling them to make informed decisions by weighing the benefits and risks of cesarean sections and ultimately reducing the number of unnecessary procedures.
The Journal of Allergy and Clinical Immunology: In Practice is an official journal of the AAAAI, focusing on practical information for the practicing clinician.
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