A meta‐analysis of the association between Caesarean section and childhood asthma
Abstract
Summary: Background Children born by Caesarean section have modified intestinal bacterial colonization and consequently may have an increased risk of developing asthma under the hygiene hypothesis. The results of previous studies that have investigated the association between Caesarean section and asthma have been conflicting. Objective To review published literature and perform a meta‐analysis summarizing the evidence in support of an association between children born by Caesarean section and asthma. Methods MEDLINE, Web Science, Google Scholar and PubMed were searched to identify relevant studies. Odds ratio (OR) and 95% confidence interval (CI) were calculated for each study from the reported prevalence of asthma in children born by Caesarean section and in control children. Meta‐analysis was then used to derive a combined OR and test for heterogeneity in the findings between studies. Results Twenty‐three studies were identified. The overall meta‐analysis revealed an increase in the risk of asthma in children delivered by Caesarean section (OR=1.22, 95% CI 1.14, 1.29). However, in this analysis, there was evidence of heterogeneity (I2=46%) that was statistically significant (P<0.001). Restricting the analysis to childhood studies, this heterogeneity was markedly decreased (I2=32%) and no longer attained statistical significance (P=0.08). In these studies, there was also evidence of an increase (P<0.001) in the risk of asthma after Caesarean section (OR=1.20, 95% CI 1.14, 12.6). Conclusion In this meta‐analysis, we found a 20% increase in the subsequent risk of asthma in children who had been delivered by Caesarean section.
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Cesarean birth is associated with adverse child health outcomes including asthma, type I diabetes, allergies, and obesity.
“established links between cesarean birth and adverse child health outcomes, including asthma, type I diabetes, allergies9–11 and obesity12”
From The relation between cesarean birth and child cognitive development (2017) · cites this paper as [11]
The estimated relations are established after controlling for socio-economic advantage associated with cesarean birth in Australia and a rich set of perinatal risk factors commonly used in child health studies.
“These relations are established after controlling for the socio-economic advantage associated with cesarean birth in Australia and a rich set of perinatal risk factors that (from meta-analyses)9, 11, 27 are commonly used in child health studies.”
From The relation between cesarean birth and child cognitive development (2017) · cites this paper as [11]
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- Authors
- Thavagnanam, S., Fleming, J., Bromley, A., Shields, M. D., & Cardwell, C. R.
- Affiliations
- Royal Belfast Hospital for Sick Children (GB)
- Royal Victoria Hospital (GB)
- Ulster Hospital (GB)
- Queen's University Belfast (GB)
- Corresponding author
- Cardwell, C. R.
- Venue
- Clinical & Experimental Allergy
- Publisher
- Wiley
- Published
- 2007-07-22
- Volume
- 38
- Issue
- 4
- Pages
- 629-633
- ISSN
- 0954-7894 (ISSN-L)
- 1365-2222
- OpenAlex
- W2019018422
- Cited by
- 651
- References
- 41
- Citations by year
- 2026: 8 · 2025: 16 · 2024: 24 · 2023: 30 · 2022: 30 · 2021: 38 · 2020: 60 · 2019: 49 · 2018: 49 · 2017: 59 · 2016: 55 · 2015: 50 · 2014: 52 · 2013: 28 · 2012: 35
- FWCI
- 1.40
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Clinical & Experimental Allergy (publishedVersion)
- PubMed (publishedVersion)
- Research Portal (Queen's University Belfast) (submittedVersion)
- Topics
- Health Sciences › Medicine › Physiology › Asthma and respiratory diseases
- Health Sciences › Medicine › Obstetrics and Gynecology › Maternal and Perinatal Health Interventions
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Gut microbiota and health
- Keywords
- cesarean section, childhood asthma, hygiene hypothesis, intestinal bacterial colonization, mode of delivery, asthma risk, heterogeneity of study results
- MeSH terms
- Adolescent, Asthma, Cesarean Section, Child, Child, Preschool, Female, Humans, Infant, Pregnancy, Risk Factors, Odds Ratio, Immunophenotyping
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