MOE-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200092, China.
Laboratory of Respiratory Disease, Affiliated Hospital of Guilin Medical University, Guilin, 541001, China.
Sci Rep. 2017 Aug 29;7(1):9762. doi: 10.1038/s41598-017-10206-3.
Caesarean section (CS) may increase the risk of asthma and allergic diseases in children, but previous studies could not preclude the potential confounding effect of underlying medical indications for CS. We aim to assess the association between CS itself (without indications) and risks of asthma and allergic rhinitis in children. The 2014 Shanghai Children's Health, Education and Lifestyle Evaluation was a large population-based survey with cluster random probability sampling in 26 primary schools in Shanghai, China, in 2014. The mode of delivery and child history of asthma and allergic rhinitis were reported by parents. We included 12639 children in our analysis. CS without medical indication was associated with an increased risk of childhood asthma. CS without medical indication and CS for fetal complications were associated with increased risks of childhood allergic rhinitis, respectively. In children fed by exclusive breastfeeding or mixed feeding in the first four months after birth, these risks were not significant. In contrast, in children fed by exclusive formula milk, CS was highly significantly associated with childhood asthma and allergic rhinitis. In conclusion, CS without medical indication was associated with increased risks of both childhood asthma and allergic rhinitis. Breastfeeding in early infancy may attenuate these risks.
剖宫产（CS）可能会增加儿童哮喘和过敏性疾病的风险，但之前的研究不能排除 CS 潜在的医学指征混杂效应。我们旨在评估 CS 本身（无指征）与儿童哮喘和过敏性鼻炎风险之间的关联。2014 年上海儿童健康、教育和生活方式评估是一项基于人群的大型调查，在中国上海的 26 所小学采用集群随机概率抽样，于 2014 年进行。分娩方式和儿童哮喘及过敏性鼻炎的病史由家长报告。我们对 12639 名儿童进行了分析。无医学指征的 CS 与儿童哮喘风险增加相关。无医学指征的 CS 和胎儿并发症 CS 与儿童过敏性鼻炎风险增加相关。在出生后前四个月以纯母乳喂养或混合喂养的儿童中，这些风险并不显著。相比之下，在仅用配方奶喂养的儿童中，CS 与儿童哮喘和过敏性鼻炎高度相关。总之，无医学指征的 CS 与儿童哮喘和过敏性鼻炎的风险增加有关。婴儿早期母乳喂养可能会减轻这些风险。
