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
Access to the full content of this site is available only to registered healthcare professionals. Access to the full content of this site is available only to registered healthcare professionals.

Takeaway

  • 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>

Limitations

  • Site-specific and longitudinal variations in clinical practice.