Pediatr Infect Dis J. 2018 Apr;37(4):316-323. doi: 10.1097/INF.0000000000001778.
Infections are the leading cause of morbidity and mortality in children. Caesarean section as a potential risk factor for infection has recently gained interest. Delivery by caesarean section has increased greatly, with nonmedical reasons playing an increasing role. We aimed to analyze the association between mode of delivery and hospitalizations because of infection and symptoms of infection at home in early childhood.
A cohort study, based on the Odense Child Cohort, following infants from gestation until a mean age of 3.5 years. Data on hospitalization because of infections were collected from the Danish National Patient Registry. Data on symptoms of infection at home were collected via a text message-based questionnaire.
A total of 1921 children were born by vaginal delivery, 283 by elective caesarean section and 227 by acute caesarean section. An adjusted regression model showed an incidence rate ratio for hospitalizations because of infection in children born by elective caesarean section compared with children born by vaginal delivery of 1.45 (95% confidence interval: 1.16-1.80; P = 0.001). The analyses on symptoms of infection at home found no associations between any symptom of infection and mode of delivery. Symptom-specific subanalyses showed contrasting results.
Mode of delivery showed a strong association to hospitalization because of infectious disease during early childhood. Overall, no association was present between rate of symptoms of infection at home and mode of delivery.
感染是导致儿童发病和死亡的主要原因。剖宫产作为感染的潜在危险因素，最近引起了人们的关注。由于非医学原因，剖宫产的比例大幅增加。我们旨在分析分娩方式与儿童早期因感染而住院和在家中出现感染症状之间的关系。
本研究基于奥尔胡斯儿童队列，对婴儿从妊娠到平均 3.5 岁进行了随访。感染住院数据来自丹麦国家患者登记处。在家中出现感染症状的数据通过基于短信的问卷收集。
共有 1921 名儿童经阴道分娩，283 名儿童择期剖宫产，227 名儿童急症剖宫产。调整后的回归模型显示，与经阴道分娩的儿童相比，择期剖宫产分娩的儿童因感染而住院的发病率比为 1.45（95%置信区间：1.16-1.80；P = 0.001）。在家中出现感染症状的分析发现，任何感染症状与分娩方式之间均无关联。针对症状的亚组分析结果不一致。
分娩方式与儿童早期传染病住院有很强的相关性。总体而言，在家中出现感染症状的比例与分娩方式之间没有关联。
