The Association of Mode of Delivery and Common Childhood Illnesses

Georgetown University, School of Medicine, Washington, DC, USA.
Clinical Pediatrics (Impact Factor: 1.15). 06/2011; 50(11):1024-30. DOI: 10.1177/0009922811410875
Source: PubMed


Participants enrolled in a randomized control trial (RCT) were eligible for this cross-sectional study to determine if children born via cesarean (C)-section had higher rates of common infectious diseases and change in normal daily activities due to illness than children born vaginally. The RCT collected parent-reported health information and mode of delivery was assessed during follow-up calls. Parent-reported rates of infectious sequelae and changes in daily activities were compared between C-section and vaginally delivered children. In total, 72.4% of the 522 children were delivered vaginally. After accounting for age, siblings, breast-feeding as an infant, and clustering within families, C-section delivered children had significantly higher rates of cumulative infectious diseases, lower respiratory tract infections, and cough than vaginally born children. Mode of delivery appears to have some lasting effect on child health 3 to 6 years after birth, specifically respiratory health. Further research is imperative to elucidate the causative effect of mode of delivery on child health.

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    ABSTRACT: International rates of operative delivery are consistently higher than the World Health Organization determined is appropriate. This suggests that factors other than clinical indications contribute to cesarean section. Data presented here are from interviews with 115 mothers on the postnatal ward of a hospital in Northeast England during February 2006 to March 2009 after the women underwent either unscheduled or scheduled cesarean childbirth. Using thematic content analysis, we found women's accounts of their experiences largely portrayed cesarean section as everything that they had wanted to avoid, but necessary given their situations. Contrary to popular suggestion, the data did not indicate impersonalized medical practice, or that cesareans were being performed 'on request.' The categorization of cesareans into 'emergency' and 'elective' did not reflect maternal experiences. Rather, many unscheduled cesareans were conducted without indications of fetal distress and most scheduled cesareans were not booked because of 'choice.' The authoritative knowledge that influenced maternal perceptions of the need to undergo operative delivery included moving forward from 'prolonged' labor and scheduling cesarean as a prophylactic to avoid anticipated psychological or physical harm. In spontaneously defending themselves against stigma from the 'too posh to push' label that is currently common in the media, women portrayed debate on the appropriateness of cesarean childbirth as a social critique instead of a health issue. The findings suggest the 'need' for some cesareans is due to misrecognition of indications by all involved. The factors underlying many cesareans may actually be modifiable, but informed choice and healthful outcomes are impeded by lack of awareness regarding the benefits of labor on the fetal transition to extrauterine life, the maternal desire for predictability in their parturition and recovery experiences, and possibly lack of sufficient experience for providers in a variety of vaginal delivery scenarios (non-progressive labor, breech presentation, and/or after previous cesarean).
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    ABSTRACT: Objective: To investigate the effect of cesarean delivery and other predisposing factors of respiratory syncytial virus (RSV)-positive acute bronchiolitis in children. Material and method: The case-control study was conducted in three main tertiary hospitals in Kunming, China between September 2012 and July 2013. Children with first episode of wheezing diagnosed as bronchiolitis and testedfor RSV were included RSV was detected by real-time reverse transcription polymerase chain reaction. Mode ofdelivery and characteristics of children, parents, and household were interviewed and analyzed with RSV-positive status by multiple logistic regression. Results: Of 265 children, RSV-positive was found in 75.5%, and the majority of children (83.3%) were younger than 12 months. Compared to vaginal delivery, the odds of RSV-positive detection were double in children born by elective cesarean delivery (adjusted odds ratio 2.32; 95% confidence interval 1.19-4.52). Children aged less than 6 months, born in the rainy season, having maternal history of asthma and living in family that smoked more than 20 cigarettes per day were more likely to be RSV-positive. Conclusion: Children born by elective cesarean delivery increased the risk of RSV-positive acute bronchiolitis after adjusting for age, birth season, maternal asthma, and family smoking status.
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