A meta-analysis of the association between Caesarean section and childhood asthma
A meta-analysis of the association between Caesarean section and childhood asthma
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DOI：
10.1111/j.1365-2222.2007.02780.x
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发表时间：
2008-04-01
影响因子：
6.1
通讯作者：
Cardwell, C. R.
中科院分区：
文献类型：
--
作者：
Thavagnanam, S.;Fleming, J.;Cardwell, C. R.
背景剖腹产出生的儿童肠道细菌定植改变，因此在卫生假说下可能有更高的哮喘发病风险。以前的研究，剖腹产和哮喘之间的关联已经调查的结果是conflicted.Objective回顾已发表的文献，并进行荟萃分析，总结的证据，支持剖腹产出生的孩子和asthen.Methods之间的关联，检索MEDLINE，Web Science，谷歌学术和PubMed，以确定相关研究。每项研究的优势比（OR）和95%置信区间（CI）均根据剖腹产儿童和对照组儿童的哮喘患病率进行计算。然后使用Meta分析得出一个合并的OR和检验异质性的研究之间的调查结果。总体荟萃分析显示，剖腹产分娩儿童的哮喘风险增加（OR=1.22，95%CI 1.14，1.29）。然而，在该分析中，有证据表明异质性（I-2=46%）具有统计学显著性（P < 0.001）。将分析限制在儿童研究中，这种异质性显著降低（I-2=32%），不再具有统计学意义（P=0.08）。在这些研究中，也有证据表明剖腹产后哮喘的风险增加（P < 0.001）（OR=1.20，95%CI 1.14，12.6）。结论在这项荟萃分析中，我们发现剖腹产分娩的儿童随后发生哮喘的风险增加了20%。
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 (I-2=46%) that was statistically significant (P < 0.001). Restricting the analysis to childhood studies, this heterogeneity was markedly decreased (I-2=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).Conclusions In this meta-analysis, we found a 20% increase in the subsequent risk of asthma in children who had been delivered by Caesarean section.