First Department of Obstetrics and Gynaecology, Centre of Postgraduate Medical Education, Żelazna 90 Street, 01-004 Warsaw, Poland.
Second Department of Obstetrics and Gynaecology, Centre of Postgraduate Medical Education, Cegłowska 80 Street, 01-809 Warsaw, Poland.
Int J Environ Res Public Health. 2020 Oct 31;17(21):8031. doi: 10.3390/ijerph17218031.
Cesarean section is a surgical procedure, which is the most frequently performed in gynecology and obstetrics. It is commonly believed that an operative delivery is a less painful and safer mode of delivery, which translates into an increasing number of the procedures performed without medical indications. The maternal sequelae of cesarean sections are well elucidated and widely discussed in the literature, while long-term neonatal consequences still remain the issue of research and scientific dispute. The aim of the present paper was to perform a systematic review of current literature regarding pediatrics consequences of cesarean section.
We reviewed available data from PubMed, Science Direct as well as Google Scholar bases concerning early and long-term neonatal sequelae of operative deliveries. The following key words were used: "cesarean section", "caesarean section", "neonatal outcomes", "respiratory disorders", "asthma", "obesity", "overweight", and "neurological disorders". A total of 1636 papers were retrieved out of which 27 were selected for the final systematic review whereas 16 articles provided data for meta-analysis. Statistical analyses were performed using RevMan 5.4. To determine the strength of association between the caesarean section and respiratory tract infections, asthma, diabetes type 1 as well as obesity the pooled odds ratios (OR) with the 95% confidence intervals (CI) were calculated.
Conducted meta-analyses revealed that caesarean section is a risk factor for respiratory tract infections (pooled OR = 1.30 95%CI 1.06-1.60, = 0.001), asthma (pooled OR = 1.23 95%CI 1.14-1.33, < 0.00001) as well as obesity (pooled OR = 1.35 95%CI 1.29-1.41, < 0.00001) in offspring.
The results of the studies included indicated that children delivered by cesarean section more commonly developed respiratory tract infections, obesity and the manifestations of asthma than children delivered vaginally. The risk of developing diabetes mellitus type 1 or neurological disorders in offspring after caesarean section is still under discussion.
剖宫产是一种外科手术，是妇产科最常进行的手术。人们普遍认为，剖宫产是一种疼痛较轻且更安全的分娩方式，这导致越来越多的人在没有医学指征的情况下进行剖宫产。剖宫产的产妇后遗症在文献中已经得到了很好的阐述和广泛的讨论，而长期的新生儿后果仍然是研究和科学争议的问题。本文的目的是对目前关于剖宫产儿科后果的文献进行系统评价。
我们检索了 PubMed、Science Direct 和 Google Scholar 数据库中关于手术分娩的早期和长期新生儿后遗症的现有数据。使用了以下关键词：“剖宫产”、“剖腹产”、“新生儿结局”、“呼吸障碍”、“哮喘”、“肥胖”、“超重”和“神经障碍”。共检索到 1636 篇论文，其中 27 篇被选为最终的系统评价，16 篇文章提供了用于荟萃分析的数据。使用 RevMan 5.4 进行统计分析。为了确定剖宫产与呼吸道感染、哮喘、1 型糖尿病和肥胖之间的关联强度，计算了合并的优势比（OR）及其 95%置信区间（CI）。
荟萃分析显示，剖宫产是呼吸道感染（合并 OR = 1.30，95%CI 1.06-1.60， = 0.001）、哮喘（合并 OR = 1.23，95%CI 1.14-1.33， < 0.00001）和肥胖（合并 OR = 1.35，95%CI 1.29-1.41， < 0.00001）的危险因素。
纳入研究的结果表明，剖宫产分娩的儿童比阴道分娩的儿童更常见发生呼吸道感染、肥胖和哮喘表现。剖宫产术后儿童发生 1 型糖尿病或神经障碍的风险仍在讨论中。
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