Golestan University of Medical Sciences Repository

Cesarean section and the risk of pediatric crohn's disease

Malmborg, P. and Bahmanyar, S. and Grahnquist, L. and Hildebrand, H. and Montgomery, S. (2012) Cesarean section and the risk of pediatric crohn's disease. Inflammatory Bowel Diseases, 18 (4). pp. 703-708.

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Background: Crohn's disease (CD) could involve an inappropriate immune response against normal bowel flora. Disrupted or atypical patterns of microbial bowel colonization may impair development of homeostasis between gut flora and the immune system. Perinatal microbial exposures may be particularly important in stimulating intestinal immune recognition. As birth by cesarean section is thought to represent an atypical pattern of early bowel colonization, we examined its association with pediatric CD. Methods: Some 1536 patients diagnosed with pediatric CD and 15,439 controls matched by delivery unit, week of birth, sex, and born between 1973 and 2006 were identified through Swedish registers. The association of birth by cesarean section with pediatric CD was examined using conditional logistic regression, with stratification by sex and adjustment for parental socioeconomic index and maternal infections during pregnancy. Results: Birth by cesarean section is associated with a modestly increased risk for pediatric CD among boys (odds ratio OR = 1.25, 95% confidence interval CI 1.01-1.54) but not girls, (OR = 0.99, 95% CI 0.76-1.29) and elective cesarean section is associated with a modest increased risk for the entire population (OR = 1.36, 95% CI 1.02-1.80). Conclusions: This study does not suggest that the delivery procedure should be altered, but the findings may be of etiological significance in CD, indicating a potential role for perinatal exposures associated with delivery mode. Although the sex difference may have arisen by chance, the modestly increased CD risk for boys delivered by cesarean section is consistent with sex-specific differences in susceptibility to some exposures. Copyright © 2011 Crohn's & Colitis Foundation of America, Inc.

Item Type: Article
Additional Information: cited By 16
Uncontrolled Keywords: article; cesarean section; controlled study; Crohn disease; disease predisposition; elective surgery; environmental exposure; female; human; infection; major clinical study; male; newborn; pediatrics; pregnancy; priority journal; prospective study; register; risk factor; sex difference; socioeconomics; vaginal delivery, Adolescent; Adult; Cesarean Section; Child; Child, Preschool; Crohn Disease; Female; Humans; Infant; Male; Risk; Sex Factors; Sweden; Young Adult
Subjects: مقالات نمایه شده محققین دانشگاه در سایت ,Web of Science ,Scopus
Divisions: معاونت تحقیقات و فناوری
Depositing User: GOUMS
Date Deposited: 22 Jul 2017 08:50
Last Modified: 22 Jul 2017 08:52
URI: http://eprints.goums.ac.ir/id/eprint/9299

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