Li Yi, Tian Yun, Zhu Weiming, Gong Jianfeng, Gu Lili, Zhang Wei, Guo Zhen, Li Ning, Li Jieshou
Department of General Surgery, Jinling Hospital, Medical School of Nanjing University , No. 305 East Zhongshan Road, Nanjing , PR China.
Scand J Gastroenterol. 2014 Jul;49(7):834-44. doi: 10.3109/00365521.2014.910834. Epub 2014 Jun 18.
It has been considered that cesarean delivery is a risk factor for the two subtypes of inflammatory bowel diseases (IBDs): Crohn's disease (CD) and ulcerative colitis (UC). The aim of this meta-analysis was to examine the relationship between cesarean delivery and the development of IBD.
We searched the articles retrieved by PubMed, MEDLINE and EMBASE databases to identify observational studies regarding the relationship between cesarean section and the development of CD and/or UC. Pooled odds ratios were calculated for each relationship.
Nine studies evaluated the potential association between cesarean delivery and the development of IBD and met all of our inclusion criteria. The pooled data from six included studies indicated cesarean delivery was a risk factor for CD (95% confidence interval [CI]: 1.12-1.70; p = 0.003). Likewise, we observed a positive association between cesarean delivery and pediatric CD (95% CI: 1.06-1.35; p = 0.005). However, results from the four included studies for UC indicated the rate of cesarean section in UC patients was not higher than that of control subjects (95% CI: 0.87-1.32; p = 0.54). Overall, we did not observe a positive relationship between cesarean delivery and IBD (95% CI: 0.99-1.30; p = 0.08).
Results of this meta-analysis support the hypothesis that cesarean delivery was associated with the risk of CD but not of UC. The total rate of cesarean delivery of IBD patients was similar with that of control subjects.
剖宫产一直被认为是炎症性肠病（IBD）两种亚型——克罗恩病（CD）和溃疡性结肠炎（UC）的一个风险因素。本荟萃分析的目的是研究剖宫产与IBD发病之间的关系。
我们检索了通过PubMed、MEDLINE和EMBASE数据库检索到的文章，以确定关于剖宫产与CD和/或UC发病关系的观察性研究。计算每种关系的合并比值比。
九项研究评估了剖宫产与IBD发病之间的潜在关联，且均符合我们的纳入标准。六项纳入研究的汇总数据表明，剖宫产是CD的一个风险因素（95%置信区间[CI]：1.12 - 1.70；p = 0.003）。同样，我们观察到剖宫产与儿童CD之间存在正相关（95% CI：1.06 - 1.35；p = 0.005）。然而，四项纳入的关于UC的研究结果表明，UC患者的剖宫产率并不高于对照组（95% CI：0.87 - 1.32；p = 0.54）。总体而言，我们未观察到剖宫产与IBD之间存在正相关（95% CI：0.99 - 1.30；p = 0.08）。
本荟萃分析结果支持以下假设，即剖宫产与CD风险相关，但与UC风险无关。IBD患者的总体剖宫产率与对照组相似。
