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Pediatrics Consequences of Caesarean Section—A Systematic Review and Meta-Analysis

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  • Aneta Słabuszewska-Jóźwiak

    (First Department of Obstetrics and Gynaecology, Centre of Postgraduate Medical Education, Żelazna 90 Street, 01-004 Warsaw, Poland)

  • Jacek Krzysztof Szymański

    (First Department of Obstetrics and Gynaecology, Centre of Postgraduate Medical Education, Żelazna 90 Street, 01-004 Warsaw, Poland)

  • Michał Ciebiera

    (Second Department of Obstetrics and Gynaecology, Centre of Postgraduate Medical Education, Cegłowska 80 Street, 01-809 Warsaw, Poland)

  • Beata Sarecka-Hujar

    (Department of Basic Biomedical Science, Faculty of Pharmaceutical Sciences in Sosnowiec, Medical University of Silesia in Katowice, Kasztanowa 3 Street, 41-200 Sosnowiec, Poland)

  • Grzegorz Jakiel

    (First Department of Obstetrics and Gynaecology, Centre of Postgraduate Medical Education, Żelazna 90 Street, 01-004 Warsaw, Poland)

Abstract

Background: 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. Methods: 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. Results: 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, p = 0.001), asthma (pooled OR = 1.23 95%CI 1.14–1.33, p < 0.00001) as well as obesity (pooled OR = 1.35 95%CI 1.29–1.41, p < 0.00001) in offspring. Conclusions: 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.

Suggested Citation

  • Aneta Słabuszewska-Jóźwiak & Jacek Krzysztof Szymański & Michał Ciebiera & Beata Sarecka-Hujar & Grzegorz Jakiel, 2020. "Pediatrics Consequences of Caesarean Section—A Systematic Review and Meta-Analysis," IJERPH, MDPI, vol. 17(21), pages 1-17, October.
    • Handle: RePEc:gam:jijerp:v:17:y:2020:i:21:p:8031-:d:438140
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    References listed on IDEAS

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    1. Oonagh E Keag & Jane E Norman & Sarah J Stock, 2018. "Long-term risks and benefits associated with cesarean delivery for mother, baby, and subsequent pregnancies: Systematic review and meta-analysis," PLOS Medicine, Public Library of Science, vol. 15(1), pages 1-22, January.
    2. Aneta Słabuszewska-Jóżwiak & Marta Włodarczyk & Krzysztof Kilian & Zbigniew Rogulski & Michał Ciebiera & Jolanta Szymańska-Majchrzak & Kornelia Zaręba & Jacek Krzysztof Szymański & Dorota Raczkiewicz , 2020. "Does the Caesarean Section Impact on 11β HSD2 and Fetal Cortisol?," IJERPH, MDPI, vol. 17(15), pages 1-13, August.
    3. Gwinyai Masukume & Ali S Khashan & Susan M B Morton & Philip N Baker & Louise C Kenny & Fergus P McCarthy, 2019. "Caesarean section delivery and childhood obesity in a British longitudinal cohort study," PLOS ONE, Public Library of Science, vol. 14(10), pages 1-13, October.
    4. Yan Shao & Samuel C. Forster & Evdokia Tsaliki & Kevin Vervier & Angela Strang & Nandi Simpson & Nitin Kumar & Mark D. Stares & Alison Rodger & Peter Brocklehurst & Nigel Field & Trevor D. Lawley, 2019. "Stunted microbiota and opportunistic pathogen colonization in caesarean-section birth," Nature, Nature, vol. 574(7776), pages 117-121, October.
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    2. Jacek K. Szymański & Aneta Słabuszewska-Jóźwiak & Grzegorz Jakiel, 2021. "Vaginal Aging—What We Know and What We Do Not Know," IJERPH, MDPI, vol. 18(9), pages 1-10, May.
    3. Sonia Lippke & Christina Derksen & Franziska Maria Keller & Lukas Kötting & Martina Schmiedhofer & Annalena Welp, 2021. "Effectiveness of Communication Interventions in Obstetrics—A Systematic Review," IJERPH, MDPI, vol. 18(5), pages 1-27, March.
    4. Doan Thi Thuy Duong & Colin Binns & Andy Lee & Yun Zhao & Ngoc Minh Pham & Dinh Thi Phuong Hoa & Bui Thi Thu Ha, 2022. "Intention to Exclusively Breastfeed Is Associated with Lower Rates of Cesarean Section for Nonmedical Reasons in a Cohort of Mothers in Vietnam," IJERPH, MDPI, vol. 19(2), pages 1-11, January.

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