Children Delivered By Cesarean Section May Have an Increased Risk for Immune-Related Diseases

Children Delivered By Cesarean Section May Have an Increased Risk for Immune-Related Diseases

According to a study published in the journal Pediatrics, a research team from Denmark provides new evidence that the offspring of women who deliver by cesarean section may have an increased risk for certain immune-related diseases.

In the US, the cesarean section rate has increased from 4.5%, in 1965, to 32.8% in 2010 and 2011, and, thus, nearly one mother in three now gives birth by cesarean section.

Recently the American College of Obstetricians and the Society for Maternal-Fetal Medicine released new guidelines, relevant mostly for first-time mothers that are aimed at safe prevention of the primary cesarean delivery.

Epidemiological studies indicate that elective cesarean section (CS) is linked to a greater risk of developing immune diseases such as asthma, allergies, type 1 diabetes, and celiac disease.

In the Pediatrics study, Astrid Sevelsted and colleagues from the University of Copenhagen & the Danish Pediatric Asthma Center, Copenhagen University Hospital, Copenhagen, Denmark collected data from 2 million full-term children born by cesarean section, as recorded in the Danish national registries between 1977 and 2012.

The authors of this study report that children delivered by cesarean section had significantly increased risk of asthma, systemic connective tissue disorders, juvenile arthritis, inflammatory bowel disease, immune deficiencies and leukemia.

The study support the hypothesis that the perinatal life is important for later development of chronic diseases.

Sevelsted et al. discuss that the normal delivery canal exposes the child to a composite microbiome different from the one encountered during a cesarean delivery. Thus, the effect from cesarean delivery is mediated by “changes in the microbiome of the newborn”.

In an elegant recent review, Roberto Romero and Steven Korzeniewski summarize the three major mechanisms that may drive the short- and long-term consequences of cesarean delivery on the immune system, and the differences between normal delivery and the cesarean section.

This includes “1) acquisition of an atypical microbiome at birth; 2) the effect of labor on the immune system; and 3) the development of memory of the first two events through epigenetic changes that modify the nature of the immune response and predispose to immune-related disorders” (after cesarean section).

Read more: Pediatrics

Source: Cover Image: Illustration depicting Caesarean section. Author: Bruce Blaus. Blausen.com staff. "Blausen gallery 2014". Wikiversity Journal of Medicine. DOI:10.15347/wjm/2014.010. ISSN 20018762. Credit: Wikimedia Commons.

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