Abstract:Background: Perinatal conditions may be associated with future allergic disease; however, data are conflicting and incomplete for childhood allergic rhinitis (AR). The aim of this study was to examine pregnancy outcome (cesarean delivery, preterm birth, low birthweight) and offspring AR as defined by national registers.Methods: Nationwide longitudinal cohort study using prospectively recorded register data from 1 059 600 singleton livebirths born in Sweden in 2001-2012. Cox regression adjusted for infant sex a… Show more
“…The present paper showed that a negligible association exists be- Our results (asthma was not reported here as an outcome) are in line with previous studies with a longer-than-five-year follow-up and meta-analyses, which have reported the association between CS or assisted VD and allergic rhinitis or asthma. 7,8,[10][11][12][13]19 Insufficient or no associations between the delivery mode and atopic diseases have been reported in studies with a shorter follow-up 16,17 but also in two cohorts with 12 years of follow-up. 18 According to a recent finding, the association between CS and asthma was modified by sex.…”
Section: Discussionmentioning
confidence: 99%
“…5 Thus far, findings are conflicting on the relationship between delivery mode and atopy 6 ; both positive and no (or insufficient) associations have been reported. [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19] The associations have been suggested to be confounded, or the effect modified by other risk factors was related to the delivery mode or microbiota composition such as duration of breastfeeding, birth order, sex, maternal atopy or early pet exposure. 12,15,[20][21][22] A short follow-up period may also explain the insufficient or conflicting findings.…”
Background
Caesarean section (CS) has been associated with an increased risk of subsequent atopic diseases, particularly asthma and respiratory allergies, but controversial findings have also been reported. Our aim was to clarify the association between the delivery mode and longitudinal (atopic) outcomes.
Methods
The target population was identified from the population register and comprised all children born between 2001 and 2006 and living in the province of South Karelia, Finland (N = 5564). The information on the delivery mode was available for 5552 children from the Finnish Medical Birth Register. Results of allergy tests (skin prick tests, specific IgE and open food challenges, OFCs) were collected from patient records of all healthcare units in the area.
Results
By 12 years of age, the cumulative incidence of atopic sensitization was 15% for those born by normal vaginal delivery (VD), 20% (adjusted RR 1.28; 95% CI 0.99–1.65) by assisted VD, 20% (adjusted RR 1.28; 95% CI 1.02–1.61) by elective CS and 20% (adjusted RR 1.24; 95% CI 0.99–1.56) by others, for example emergency CS. Among the offspring of mothers without atopic diseases, the incidence of food allergy (positive OFC) was 6% for those born by elective CS and 2% for those born by normal VD (adjusted RR 2.41; 95% CI 1.19–4.88), while the respective incidences were 5% and 6% (adjusted RR 0.82; 95% CI 0.33–2.06) among the offspring of mothers with atopic diseases.
Conclusion
By adolescence, the cumulative incidences of atopic sensitization was highest among those born by assisted VD or CS. The incidence of food allergy was highest among those born by elective CS among the offspring of mothers without atopic diseases.
“…The present paper showed that a negligible association exists be- Our results (asthma was not reported here as an outcome) are in line with previous studies with a longer-than-five-year follow-up and meta-analyses, which have reported the association between CS or assisted VD and allergic rhinitis or asthma. 7,8,[10][11][12][13]19 Insufficient or no associations between the delivery mode and atopic diseases have been reported in studies with a shorter follow-up 16,17 but also in two cohorts with 12 years of follow-up. 18 According to a recent finding, the association between CS and asthma was modified by sex.…”
Section: Discussionmentioning
confidence: 99%
“…5 Thus far, findings are conflicting on the relationship between delivery mode and atopy 6 ; both positive and no (or insufficient) associations have been reported. [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19] The associations have been suggested to be confounded, or the effect modified by other risk factors was related to the delivery mode or microbiota composition such as duration of breastfeeding, birth order, sex, maternal atopy or early pet exposure. 12,15,[20][21][22] A short follow-up period may also explain the insufficient or conflicting findings.…”
Background
Caesarean section (CS) has been associated with an increased risk of subsequent atopic diseases, particularly asthma and respiratory allergies, but controversial findings have also been reported. Our aim was to clarify the association between the delivery mode and longitudinal (atopic) outcomes.
Methods
The target population was identified from the population register and comprised all children born between 2001 and 2006 and living in the province of South Karelia, Finland (N = 5564). The information on the delivery mode was available for 5552 children from the Finnish Medical Birth Register. Results of allergy tests (skin prick tests, specific IgE and open food challenges, OFCs) were collected from patient records of all healthcare units in the area.
Results
By 12 years of age, the cumulative incidence of atopic sensitization was 15% for those born by normal vaginal delivery (VD), 20% (adjusted RR 1.28; 95% CI 0.99–1.65) by assisted VD, 20% (adjusted RR 1.28; 95% CI 1.02–1.61) by elective CS and 20% (adjusted RR 1.24; 95% CI 0.99–1.56) by others, for example emergency CS. Among the offspring of mothers without atopic diseases, the incidence of food allergy (positive OFC) was 6% for those born by elective CS and 2% for those born by normal VD (adjusted RR 2.41; 95% CI 1.19–4.88), while the respective incidences were 5% and 6% (adjusted RR 0.82; 95% CI 0.33–2.06) among the offspring of mothers with atopic diseases.
Conclusion
By adolescence, the cumulative incidences of atopic sensitization was highest among those born by assisted VD or CS. The incidence of food allergy was highest among those born by elective CS among the offspring of mothers without atopic diseases.
“…13 Our results are consistent with previous research, 9,10,12,17,22,29 however, some studies contradict our conclusions or show no association. 15,21,30,31 Our study makes a significant addition to the literature due to its longitudinal design including repeated measurements of outcome throughout childhood up to early adulthood. Additionally, our results were replicated in an independent data set.…”
This is an open access article under the terms of the Creat ive Commo ns Attri butio n-NonCo mmerc ial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.
“…It is well known that babies born by cesarean section might have a modified microbiota, and this can influence the number of obstructive lung diseases in young children, 6 similar to the use of antibiotics during pregnancy or early life, which also modifies the microbiota 7 . Overall, the factors associated with pregnancy or early‐life events of the development of bronchiolitis and asthma have been frequently studied recently 8‐11 (Figure 1). …”
Risk factors for bronchiolitis and asthma, and COVID-19 symptoms in young children This issue opens with two educational articles destined to update the readers on current drug allergy and food allergy issues. In the first review article, Marina Atanaskovic Markovic, PAI Associate Editor for drug allergies, addresses key issues in this area. 1 In particular, she examines the overdiagnosis of beta-lactam allergy in
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