A meta‐analysis of the association between Caesarean section and childhood asthma
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- 22 July 2007
- journal article
- research article
- Published by Wiley in Clinical and Experimental Allergy
- Vol. 38 (4), 629-633
- https://doi.org/10.1111/j.1365-2222.2007.02780.x
Abstract
Background Children born by Caesarean section have modified intestinal bacterial colonization and consequently may have an increased risk of developing asthma under the hygiene hypothesis. The results of previous studies that have investigated the association between Caesarean section and asthma have been conflicting. Objective To review published literature and perform a meta‐analysis summarizing the evidence in support of an association between children born by Caesarean section and asthma. Methods MEDLINE, Web Science, Google Scholar and PubMed were searched to identify relevant studies. Odds ratio (OR) and 95% confidence interval (CI) were calculated for each study from the reported prevalence of asthma in children born by Caesarean section and in control children. Meta‐analysis was then used to derive a combined OR and test for heterogeneity in the findings between studies. Results Twenty‐three studies were identified. The overall meta‐analysis revealed an increase in the risk of asthma in children delivered by Caesarean section (OR=1.22, 95% CI 1.14, 1.29). However, in this analysis, there was evidence of heterogeneity (I2=46%) that was statistically significant (PI2=32%) and no longer attained statistical significance (P=0.08). In these studies, there was also evidence of an increase (P<0.001) in the risk of asthma after Caesarean section (OR=1.20, 95% CI 1.14, 12.6). Conclusion In this meta‐analysis, we found a 20% increase in the subsequent risk of asthma in children who had been delivered by Caesarean section.Keywords
This publication has 42 references indexed in Scilit:
- Preterm delivery and asthma: A systematic review and meta-analysisJournal of Allergy and Clinical Immunology, 2006
- Mode of Delivery Is Associated With Asthma and Allergy Occurrences in ChildrenAnnals of Epidemiology, 2006
- Childhood asthma hospitalization risk after cesarean delivery in former term and premature infantsAnnals of Allergy, Asthma & Immunology, 2005
- The early origins of asthma: nature, nurture, or parturition?Annals of Allergy, Asthma & Immunology, 2005
- Measuring inconsistency in meta-analysesBMJ, 2003
- Quantifying heterogeneity in a meta‐analysisStatistics in Medicine, 2002
- Risk of childhood asthma and allergic rhinitis in relation to pregnancy complicationsJournal of Allergy and Clinical Immunology, 2000
- Risk of Preschool Asthma: Incidence, Hospitalization, Recurrence, and Readmission ProbabilityJournal of Asthma, 1996
- Food and drug reactions, wheezing, and eczema in preterm infants.Archives of Disease in Childhood, 1990
- Meta-analysis in clinical trialsControlled Clinical Trials, 1986