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Discover Pediatric Collections on COVID-19 and Racism and Its Effects on Pediatric Health

American Academy of Pediatrics
Article

Cesarean Section and Chronic Immune Disorders

Astrid Sevelsted, Jakob Stokholm, Klaus Bønnelykke and Hans Bisgaard
Pediatrics January 2015, 135 (1) e92-e98; DOI: https://doi.org/10.1542/peds.2014-0596
Astrid Sevelsted
aCopenhagen Prospective Studies on Asthma in Childhood, Faculty of Health and Medical Sciences, University of Copenhagen & Danish Pediatric Asthma Center, Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark; and
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Jakob Stokholm
aCopenhagen Prospective Studies on Asthma in Childhood, Faculty of Health and Medical Sciences, University of Copenhagen & Danish Pediatric Asthma Center, Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark; and
bDepartment of Pediatrics, Naestved Hospital, Naestved, Denmark
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Klaus Bønnelykke
aCopenhagen Prospective Studies on Asthma in Childhood, Faculty of Health and Medical Sciences, University of Copenhagen & Danish Pediatric Asthma Center, Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark; and
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Hans Bisgaard
aCopenhagen Prospective Studies on Asthma in Childhood, Faculty of Health and Medical Sciences, University of Copenhagen & Danish Pediatric Asthma Center, Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark; and
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Abstract

OBJECTIVES: Immune diseases such as asthma, allergy, inflammatory bowel disease, and type 1 diabetes have shown a parallel increase in prevalence during recent decades in westernized countries. The rate of cesarean delivery has also increased in this period and has been associated with the development of some of these diseases.

METHODS: Mature children born by cesarean delivery were analyzed for risk of hospital contact for chronic immune diseases recorded in the Danish national registries in the 35-year period 1977–2012. Two million term children participated in the primary analysis. We studied childhood diseases with a suspected relation to a deviant immune-maturation and a debut at young age. The effect of cesarean delivery on childhood disease incidences were estimated by means of confounder-adjusted incidence rate ratios with 95% confidence intervals obtained in Poisson regression analyses.

RESULTS: Children delivered by cesarean delivery had significantly increased risk of asthma, systemic connective tissue disorders, juvenile arthritis, inflammatory bowel disease, immune deficiencies, and leukemia. No associations were found between cesarean delivery and type 1 diabetes, psoriasis, or celiac disease.

CONCLUSIONS: Cesarean delivery exemplifies a shared environmental risk factor in early life associating with several chronic immune diseases. Understanding commonalities in the underlying mechanisms behind chronic diseases may give novel insight into their origin and allow prevention.

  • cesarean section
  • inflammatory disease
  • origins
  • asthma
  • prenatal
  • programming
  • Accepted October 21, 2014.
  • Copyright © 2015 by the American Academy of Pediatrics

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Pediatrics
Vol. 135, Issue 1
1 Jan 2015
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Cesarean Section and Chronic Immune Disorders
Astrid Sevelsted, Jakob Stokholm, Klaus Bønnelykke, Hans Bisgaard
Pediatrics Jan 2015, 135 (1) e92-e98; DOI: 10.1542/peds.2014-0596

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Cesarean Section and Chronic Immune Disorders
Astrid Sevelsted, Jakob Stokholm, Klaus Bønnelykke, Hans Bisgaard
Pediatrics Jan 2015, 135 (1) e92-e98; DOI: 10.1542/peds.2014-0596
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