|ASTHMA AND CESAREAN SECTION|
Cesarean Section and Risk of Severe Childhood Asthma: A Population-Based Cohort Study. J Ped 2008; DOI:10.1016/j.jpeds.2008.01.02
This Norwegian study shows that babies born by Caesarean section have a 50% increased risk of developing asthma compared to babies born naturally. Emergency Caesarean sections increase the risk even further. This data comes from 1.7 million births registered at the Medical Birth Registry at the Norwegian Institute of Public Health.
Compared to children born in the natural way (i.e. spontaneously and vaginally), children born by Caesarean section had an approximately 50 % increased risk of developing asthma. Children born vaginally, but with assistance from vacuum or forceps, had a 20 % increased risk of asthma.
For children born between 1988 and 1998, planned Caesarean section was associated with an approximately 40% increased risk of asthma while emergency Caesarean section was associated with a 60 % increased risk.
There are two main theories about why Caesarean sections could cause asthma. The first is that babies who are born by Caesarean section are not exposed to their mothers' vaginal flora during birth, which is detrimental for development of the immune system. The other is that babies born by Caesarean section have more breathing problems after birth because they are less exposed to stress hormones and compression of the chest, since these mechanisms contribute to emptying the lungs of amniotic fluid. The fact that emergency Caesarean section apparently has a stronger effect on the risk of asthma than planned Caesarean section cannot easily be explained by any of these theories.
The authors looked at over 1.7 million births reported to the Medical Birth Registry at the Norwegian Institute of Public Health in the period 1967-1998. Multiple births and children with congenital malformations were excluded. The children were monitored until they became 18 years old or through 2002.
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