Mode of delivery and development of atopic disease during the first 2 years of life
- 1 February 2004
- journal article
- research article
- Published by Wiley in Pediatric Allergy and Immunology
- Vol. 15 (1), 48-54
- https://doi.org/10.1046/j.0905-6157.2003.00101.x
Abstract
It has been hypothesized that cesarean delivery might have an impact on the development of atopic diseases because of its gut flora modulating properties. In the present study, we analysed the association between cesarean delivery and atopic diseases using data of 2500 infants enrolled in the LISA‐Study, a German prospective multicenter birth cohort study. Data on symptoms and physician‐diagnosed atopic diseases were gathered by questionnaires shortly after birth and at infant's age 6, 12, 18, and 24 months. In addition, sensitization to common food and inhalant allergens was assessed by measuring specific immunoglobulin E (IgE) using the CAP‐RAST FEIA method at the age of 2 yr. Confounder‐adjusted odds ratios (aOR) with 95% confidence intervals (CI) were calculated by multiple logistic regression. We found a positive association between cesarean delivery and occurrence of at least one episode of wheezing [aOR 1.31 (95% CI 1.02–1.68)] and of recurrent wheezing [1.41 (1.02–1.96)] during the first 2 yr of life. Furthermore, effect estimates for allergic sensitization defined as at least one specific IgE ≥0.70 kU/l against any allergen [1.48 (0.98–2.24)], against food allergens [1.64 (1.03–2.63)], and against inhalant allergens [1.75 (0.98–3.12)] were increased. Symptoms of atopic dermatitis [1.21 (0.92–1.59)], physician‐diagnosed atopic dermatitis [1.04 (0.79–1.39)], and symptoms of allergic rhinoconjunctivitis [1.40 (0.80–2.44)] were only marginally increased in children delivered by cesarean section. In conclusion, our results suggest that cesarean delivery may be an additional risk factor for wheezing and allergic sensitization at least to food allergens up to the age of 2 yr. This should be considered when cesarean section is done for other than medical reasons.Keywords
This publication has 20 references indexed in Scilit:
- Mode of Delivery and Asthma – Is There a Connection?Pediatric Research, 2002
- Mode of Delivery and Asthma - Is There a Connection?Pediatric Research, 2002
- Prevalence of atopy and asthma in eastern versus western Europe: why the difference?Annals of Allergy, Asthma & Immunology, 2001
- The pattern of atopic sensitization is associated with the development of asthma in childhoodJournal of Allergy and Clinical Immunology, 2001
- Caesarean section and risk of asthma and allergy in adulthoodJournal of Allergy and Clinical Immunology, 2001
- Distinct patterns of neonatal gut microflora in infants in whom atopy was and was not developingJournal of Allergy and Clinical Immunology, 2001
- Risk of childhood asthma and allergic rhinitis in relation to pregnancy complicationsJournal of Allergy and Clinical Immunology, 2000
- The intestinal microflora in allergic Estonian and Swedish 2‐year‐old childrenClinical and Experimental Allergy, 1999
- Fecal Microflora in Healthy Infants Born by Different Methods of Delivery: Permanent Changes in Intestinal Flora After Cesarean DeliveryJournal of Pediatric Gastroenterology and Nutrition, 1999
- The absence of gut flora, the doses of antigen ingested and aging affect the long-term peripheral tolerance induced by ovalbumin feeding in miceResearch in Immunology, 1996