Caesarean birth linked to infection-related hospitalisation in early childhood

  • Chaplin AB & al.
  • Psychol Med
  • 13 Nov 2020

  • curated by Sarfaroj Khan
  • UK Clinical Digest
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  • Compared with vaginal birth, caesarean section (CS) was associated with an increased risk of infection-related hospitalisation in offspring up to 5 years of age.
  • Both elective and emergency CS births were associated with infection-related hospitalisation, with the highest increased risk following elective CS.

Why this matters

  • Findings may contribute to the global effort to reduce the rates of elective CS that are not medically indicated.

Study design

  • This multinational, population-based study included 7,174,787 recorded singleton live births between 1996 and 2015 using record-linked birth and hospitalisation data from Denmark, Scotland, England and Australia.
  • The risk of overall and clinical type of infection by mode of birth, vaginal or CS (emergency/elective), was estimated.
  • Funding: None disclosed.

Key results

  • Overall, 1,681,966 births were by CS, and of these, 727,755 were elective.
  • During follow-up, 1,502,537 (21%) children had ≥1 infection-related hospitalisation.
  • CS-born children vs vaginally born children were at a greater risk of infection-related hospitalisation (HR from random effects model, HR, 1.10, 95% CI, 1.09-1.12; P<.001>
  • Compared with vaginal birth, the risk was higher following both elective (HR, 1.13; 95% CI, 1.12-1.13) and emergency CS (HR, 1.09; 95% CI, 1.06-1.12; P<.001 for both>
  • Increased risks persisted to 5 years and were highest for respiratory, gastrointestinal and viral infections.
  • In the low-risk maternal subpopulation, the risk of infection-related hospitalisation in children born by CS was similar to overall findings (elective CS: HR, 1.14; 95% CI, 1.12-1.15; P<.001 emergency cs: hr ci>


  • Site-specific and longitudinal variations in clinical practice.