Long‑Term Infant Health Outcomes Associated With Cesarean Section Compared With Vaginal Birth

Abstract

Background: Mode of delivery has been hypothesized to be a modifiable perinatal factor affecting long-term child health via several proposed pathways, including through mechanisms of early gut microbiota colonization, variations in exposure to stress hormones, and epidemiological associations to immune and metabolic diseases. Objective: To estimate the strengths and differences between the incidence rates of selected chronic health outcomes (asthma, obesity, allergic rhinitis, recurrent respiratory infections, and eczema) in babies and children born by cesarean section (CS) vs. vaginal delivery (VD) through a simulated cross-sectional cohort study design. Data was collected and analyzed descriptively, by independent samples t-tests, chi-square tests, and multivariate logistic regression, as in a typical analysis process in SPSS, on a cross-sectional dataset of 105 mother-infant pairs (50 CS and 55 VD). Results: Rates of childhood asthma were higher after CS (24.0%) than VD (10.9%), and comparable rates of recurrent respiratory infections (26.0% vs. 18.2%) and childhood obesity (18.0% vs. 10.9%) were observed, although none of the individual chi-square comparisons were significant (p<0.05) in this limited simulated sample. Cesarean section was associated with approximately double the odds of any long-term adverse outcome compared to vaginal delivery (odds ratio [OR] = 2.14; 95% confidence interval: 0.90–5.06), but this result did not reach the level of statistical significance (p = 0.084) in the multivariate logistic regression analysis. The association with adverse long-term outcomes was a consistent pattern across all five measures analyzed, similar to other studies, and cesarean section was associated with the long-term outcomes.