Wheeze and Food Allergies in Children Born via Cesarean Section - The Upstate KIDS Study.

We examined whether cesarean delivery (CD) increased the risk of wheeze or food allergy in early childhood compared to vaginal delivery and whether these associations were mediated by breastfeeding. The study population was the Upstate KIDS cohort (2008-2010) of mothers and infants from New York State (excluding New York City). Infant's wheeze was reported by questionnaire every 4-6 months until 3 years as was food allergies beginning at 8 months. Modified Poisson regression was used to compare risks of the outcomes by mode of delivery (MOD). Potential confounders were identified a priori using directed acyclic graphs.Emergency CD (n=1,356) was associated with elevated risk of wheeze, adjusting for pregnancy complications, maternal atopy, gestational age, birthweight and pregnancy smoking (Risk Ratio [RR] 2.47, 95% confidence interval [CI]:1.31, 4.66); and an increased risk of food allergy, adjusting for maternal atopy, pre-pregnancy body mass index, pregnancy smoking and parity (RR 3.02, 95% CI:1.26, 7.25). Neither outcome was significantly associated with planned CD (n=1,565 infants). Breastfeeding mediated the association between MOD and wheeze but not food allergy. Other factors not associated with early-life microbial transfer, but relating to the development of the outcomes, may contribute to the association between MOD and wheezing/food allergy. PMID: 30475936 [PubMed - as supplied by publisher]
Source: Am J Epidemiol - Category: Epidemiology Authors: Tags: Am J Epidemiol Source Type: research