Dydensborg Sander Stine, Hansen Anne Vinkel, Størdal Ketil, Andersen Anne-Marie Nybo, Murray Joseph A, Husby Steffen
Hans Christian Andersen Children's Hospital, Odense University Hospital, Odense, Denmark.
Institute of Clinical Research, Faculty of Health Science, University of Southern Denmark, Odense, Denmark.
Clin Epidemiol. 2018 Mar 19;10:323-332. doi: 10.2147/CLEP.S152168. eCollection 2018.
The purpose of this study was to investigate the association between mode of delivery and the risk of celiac disease in two large population-based birth cohorts with different prevalence of diagnosed celiac disease.
This is an observational register-based cohort study using two independent population cohorts. We used data from administrative registers and health administrative registers from Denmark and Norway and linked the data at the individual level. We included all children who were born in Denmark from January 1, 1995 to December 31, 2010 and all children who were born in Norway from January 1, 2004 to December 31, 2012.
We included 1,051,028 children from Denmark. Cesarean sections were registered for 196,512 children (18.9%). Diagnosed celiac disease was registered for 1,395 children (0.13%). We included 537,457 children from Norway. Cesarean sections were registered for 90,128 children (16.8%). Diagnosed celiac disease was registered for 1,919 children (0.35%). We found no association between the mode of delivery and the risk of diagnosed celiac disease. The adjusted odds ratio for celiac disease for children delivered by any type of cesarean section compared to vaginal delivery was 1.11 (95% CI: 0.96-1.29) in the Danish cohort and 0.96 (95% CI: 0.84-1.09) in the Norwegian cohort. The adjusted odds ratio for celiac disease for children delivered by elective cesarean section compared to vaginal delivery was 1.20 (95% CI: 1.00-1.43) in the Danish cohort and 0.96 (95% CI: 0.79-1.17) in the Norwegian cohort.
In this large registry-based study, mode of delivery was not associated with an increased risk of diagnosed celiac disease.
本研究旨在调查在两个乳糜泻患病率不同的大型人群出生队列中，分娩方式与乳糜泻风险之间的关联。
这是一项基于登记处的观察性队列研究，使用了两个独立的人群队列。我们使用了来自丹麦和挪威的行政登记处及卫生行政登记处的数据，并在个体层面将这些数据进行了关联。我们纳入了1995年1月1日至2010年12月31日在丹麦出生的所有儿童，以及2004年1月1日至2012年12月31日在挪威出生的所有儿童。
我们纳入了来自丹麦的1,051,028名儿童。有196,512名儿童（18.9%）登记为剖宫产。有1,395名儿童（0.13%）登记为确诊乳糜泻。我们纳入了来自挪威的537,457名儿童。有90,128名儿童（16.8%）登记为剖宫产。有1,919名儿童（0.35%）登记为确诊乳糜泻。我们发现分娩方式与确诊乳糜泻的风险之间没有关联。在丹麦队列中，与阴道分娩相比，任何类型剖宫产分娩的儿童患乳糜泻的校正优势比为1.11（95%可信区间：0.96 - 1.29），在挪威队列中为0.96（95%可信区间：0.84 - 1.09）。在丹麦队列中，与阴道分娩相比，择期剖宫产分娩的儿童患乳糜泻的校正优势比为1.20（95%可信区间：1.00 - 1.43），在挪威队列中为0.96（95%可信区间：0.79 - 1.17）。
在这项基于大型登记处的研究中，分娩方式与确诊乳糜泻风险增加无关。
