The prevalence of food allergy in cesarean-born children aged 0–3 years: A systematic review and meta-analysis of cohort studies

Abstract

PurposePrevious studies reported a higher risk of food allergy for cesarean-born children than vaginal-born children. This study aims to systematically compare the prevalence of food allergy among cesarean-born and vaginal-born children aged 0–3 years.MethodsThree English and two Chinese databases were searched using terms related to food allergies and cesarean sections. Cohort studies that reported the prevalence of food allergy in cesarean-born and vaginal-born children aged 0–3 years were included. Two reviewers performed study selection, quality assessment, and data extraction. The pooled prevalence of food allergy in cesarean-born and vaginal-born children was compared by meta-analysis.ResultsNine eligible studies, with 9,650 cesarean-born children and 20,418 vaginal-born children aged 0–3 years, were included. Of them, 645 cesarean-born children and 991 vaginal-born children were identified as having food allergies. The pooled prevalence of food allergy was higher in cesarean-born children (7.8%) than in vaginal-born children (5.9%). Cesarean section was associated with an increased risk of food allergy [odds ratio (OR): 1.45; 95% confidence interval (CI): 1.03–2.05] and cow's milk allergy (OR: 3.31; 95% CI: 1.98–5.53). Additionally, cesarean-born children with a parental history of allergy had an increased risk of food allergy (OR: 2.60; 95% CI: 1.28–5.27).ConclusionThis study suggests that cesarean sections was associated with an increased risk of food and cow's milk allergies in children aged 0–3 years. Cesarean-born children with a parental history of allergy demonstrated a higher risk for food allergy than did vaginal-born children. These results indicate that caregivers should be aware of the risks of food allergies in cesarean-born children, reducing the risk of potentially fatal allergic events. Further research is needed to identify the specific factors affecting food allergies in young children.Systematic Review Registrationhttp://www.crd.york.ac.uk/prospero, identifier: International Prospective Register of Systematic Reviews (NO. CRD42019140748).

Nurturing Infants to Prevent Atopic Dermatitis and Food Allergies: A Longitudinal Study

“…We assume that the result in our study is pertinent, especially given the notably high rate of cesarean sections within the specific population. Conversely, cesarean section was found to be associated with an increased risk of food allergies in infants with AD, in line with previous studies that have reported how cesarean section can disrupt gut bacterial colonization and lead to a reduction in specific beneficial bacteria [36].The presence of a home garden emerged as a significant factor associated with a higher likelihood of atopic dermatitis (AD) in our study. This finding contrasts with previous research suggesting that a greener environment is typically protective against allergies, particularly allergic asthma and allergic rhinitis [37].…”

Sociodemographic inequities in food allergy: Insights on food allergy from birth cohorts

“…Another recent meta‐analysis 46 of nine cohort studies evaluating prevalence of FA in Cesarean‐born and vaginally‐born children aged 0–3 years, found Cesarean section to be associated with an increased risk of any FA, as well as cow's milk allergy specifically, among children 0–3 years of age. Taken together, these birth cohort studies highlight the need to consider birth mode as a potentially‐relevant covariate when modeling sociodemographic differences in FA outcomes, given that in the US non‐Hispanic Black babies are significantly more likely to be born via Cesarean section 47 .…”

Redefining the Role of Nutrition in Infant Food Allergy Prevention: A Narrative Review

“…Among the children of women without atopic diseases, the incidence of food allergy was 6% for those born by elective CS and 2% for those born by normal VD, while respective incidences were 5% and 6% among the offspring of mothers with atopic diseases [ 49 ]. A separate Australian study did not show an association between CS and food allergy, yet a recent systematic review and meta-analysis concluded that CS was associated with an increased risk of food and cow’s milk allergies in children aged 0–3 years [ 50 , 51 ].…”