Cesarean section and risk of severe childhood asthma: A population-based cohort study
Cesarean section and risk of severe childhood asthma: A population-based cohort study
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DOI：
10.1016/j.jpeds.2008.01.029
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发表时间：
2008-07-01
影响因子：
5.1
通讯作者：
Irgens, Lorentz M.
中科院分区：
文献类型：
--
作者：
Tollanes, Mette C.;Moster, Dag;Irgens, Lorentz M.
目的探讨剖宫产（CS）分娩与哮喘发病的关系。研究设计：一项基于人群的队列研究，1967年至1998年挪威医学出生登记处报告的1，756，700例单胎婴儿，随访至IS岁或2002年。暴露是分娩方式（自1988年起，自发阴道、器械阴道或CS，计划和紧急CS分开）。结果是哮喘在国家保险计划中登记，该计划为患有严重慢性病的儿童的家庭提供现金福利。我们使用多变量考克斯比例风险模型来研究暴露和outcome.Results之间的关联哮喘的累积发病率为4.0/1000。与自然阴道分娩的儿童相比，CS分娩的儿童发生哮喘的风险增加52%（调整后的风险比[HR] = 1.52; 95%置信区间[CI] = 1.42 - 1.62）。在1988年和1998年之间，计划和紧急CS分别与42%（HR = 1.42; 95%CI = 1.25至1.61）和59%（HR = 1.59; 95%CI = 1.44至1.75）的哮喘风险增加，分别。与计划的CS相比，与紧急CS的可能更强的关联可能值得研究可能的因果机制。
Objective To explore the possible association between delivery by cesarean section (CS) and later development of asthma.Study design A population-based cohort study of 1,756,700 singletons reported to the Medical Birth Registry of Norway between 1967 and 1998, followed up to age IS years or the year 2002. Exposure was the mode of delivery (spontaneous vaginal, instrumental vaginal, or CS, with planned and emergency CS separately from 1988 onward). Outcome was asthma registered in the National Insurance Scheme, which provides cash benefits to families of children with severe chronic illnesses. We used multivariate Cox proportional hazard models to examine associations between exposure and outcome.Results The cumulative incidence of asthma was 4.0/1000. Children delivered by CS had a 52% increased risk of asthma compared with spontaneously vaginally delivered children (adjusted hazard ratio [HR] = 1.52; 95% confidence interval [CI] = 1.42 to 1.62). Between 1988 and 1998, planned and emergency CS was associated with a 42% (HR = 1.42; 95% CI = 1.25 to 1.61) and 59% (HR = 1.59; 95% CI = 1.44 to 1.75) increased risk of asthma, respectively.Conclusion We found a moderately increased risk of asthma in the children delivered by CS. The possibly stronger association with emergency CS compared with planned CS could be worth pursuing to investigate possible causal mechanisms.