Caesarean section increases the risk of hospital care in childhood for asthma and gastroenteritis
Caesarean section increases the risk of hospital care in childhood for asthma and gastroenteritis
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DOI：
10.1046/j.1365-2222.2003.01667.x
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发表时间：
2003-06-01
影响因子：
6.1
通讯作者：
Källén, K
中科院分区：
文献类型：
--
作者：
Håkansson, S;Källén, K
目的探讨剖腹产（CS）是否增加儿童哮喘和胃肠炎的风险与参考阴道分娩（VD）的儿童出生。方法回顾性研究数据从瑞典医疗服务注册-医疗出生登记处（MBR）和出院登记处（HDR）。数据来自没有任何背景/围产期发病率的妇女和没有任何新生儿并发症的儿童。在HDR中发现的至少1岁的儿童被视为病例，而在HDR中未发现或因哮喘或胃肠炎以外的其他原因住院的儿童被定义为对照组。计算出生年份、母亲年龄、产次和孕早期吸烟分层的比值比（OR）。研究比较了CS儿童和CS儿童的VD同胞因哮喘或胃肠炎住院治疗的风险。结果CS患儿哮喘的OR为1.31 [95%可信区间（CI）1.23-1.40]。胃肠炎的OR为1.31（95%CI 1.24-1.38）。同时发生哮喘和胃肠炎的CS儿童的OR进一步增加（1.74，95%CI 1.36-2.23）。CS儿童的VD同胞患哮喘的风险没有显著增加，而VD同胞患胃肠炎的风险略有增加。CS儿童有一个整体的增加，在医院发病率相比VD children.Conclusion有一个显着增加的风险，为发展中国家的哮喘和/或胃肠炎的症状，激励入院治疗CS儿童年龄大于1岁。推测CS患儿肠道定植模式紊乱可能是一种常见的致病因素。
Objective To investigate if caesarean section (CS) increases the risk for childhood asthma and gastroenteritis with reference made to children born with vaginal delivery (VD).Methods Retrospective study of data from linked Swedish medical service registers - Medical Birth Registry (MBR) and Hospital Discharge Registry (HDR). Data were obtained from women without any background/perinatal morbidity noted, and from children without any neonatal complications. Children that had reached at least 1 year of age and were found in the HDR were considered as cases, whereas children not found in the HDR or hospitalized for other causes than asthma or gastroenteritis were defined as controls. Odds ratios (OR) stratified for year of birth, maternal age, parity and smoking in early pregnancy were calculated. Investigations were made comparing the risk for in hospital treatment for asthma or gastroenteritis in CS children and in VD siblings of CS children. The overall inpatient morbidity in CS and VD children were also investigated.Results The OR for asthma in CS children was 1.31 [95% confidence interval (CI) 1.23-1.40]. The same OR, 1.31, was found for gastroenteritis (95% CI 1.24-1.38). The OR for CS children having experienced both asthma and gastroenteritis was further increased (1.74, 95% CI 1.36-2.23). The risk for asthma in VD siblings of CS children was not significantly increased, whereas VD siblings experienced a slightly increased risk for gastroenteritis. CS children had an increased overall in hospital morbidity when compared to VD children.Conclusion There is a significant increase of the risk for developing symptoms of asthma and/or gastroenteritis that motivates admission for hospital care in CS children older than 1 year. It is speculated that a disturbed intestinal colonization pattern in CS children may be a common pathogenic factor.