FRIDAY, Nov. 20, 2020 — Birth by cesarean section (CS) is associated with an increased risk for infection-related hospitalization in early childhood, according to a study published online Nov. 19 in PLOS Medicine.
Jessica E. Miller, M.P.H., Ph.D., from the Royal Children’s Hospital in Parkville, Australia, and colleagues conducted a multicountry population-based cohort study of all recorded singleton live births from Jan. 1, 1996, to Dec. 31, 2015, using record-linked birth and hospitalization data. The mode of birth was classified as vaginal or CS (emergency/elective).
Data were included for 7,174,787 live recorded births, including 23 percent by CS, of which 43 percent were elective. The researchers found that 21 percent of the offspring had at least one infection-related hospitalization. The risk for infection was elevated among CS-born children compared with vaginally born children (hazard ratio, 1.10). The risk was increased following elective and emergency CS (hazard ratios, 1.13 and 1.09, respectively). Elevated risk persisted to five years, with the highest risks seen for respiratory, gastrointestinal, and viral infections. In prespecified subanalyses of children born to mothers at low obstetric risk, the findings were comparable.
“Our findings have implications for clinical practice and public health policy,” the authors write. “Infection is the leading cause of early childhood hospitalization, and this potential risk should be considered when discussing obstetric management, especially if vaginal birth is clinically safe and appropriate.”
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