Study on the Association between Cesarean Section Birth and Asthma Risk in the Pediatric Population of the Health Area of Palencia between 1993 and 2020

Main Article Content

Jesús Rodríguez Calleja https://orcid.org/0009-0002-0171-6062
Eva María Jiménez Hernández
Alba Macías Panedas
José Fernando Soltero Carracedo
Carla González García
María Paz Barrio Alonso
María Teresa Cantero Tejedor
José Elviro Fernández Alonso

Keywords

cesarean birth, asthma risk, pediatric population

Abstract

Introduction and Objectives: Both asthma prevalence and the percentage of cesarean sections have increased in parallel in recent years. Research studies suggest an increased risk of developing atopic diseases and asthma after cesarean section birth compared to vaginal delivery. The main objective of this study is to analyze the risk of asthma admission after cesarean section birth compared to vaginal delivery in the pediatric population.


Population and Methods: Retrospective observational analytical case-control study from 1993 to 2020. The cases include all admitted patients to our health area hospital, for patients aged 7 to 16 diagnosed with asthma. For each case, a control without a diagnosis of asthma is selected with the same age, and that has also caused an episode of admission.


Results: A total of 290 admission episodes with a diagnosis of asthma were obtained, caused by 155 patients. Out of these, 145 cases with documented delivery types were selected. For cases, 155 controls were selected. The historical proportion of cesarean sections in the asthmatic group is 18.6%, compared to 14.2% in the non-asthmatic group. There is a statistically non-significant difference of 4.4% more cesarean sections in the asthmatic group compared to the control group.


Discussion: We have not demonstrated a statistically significant association between being born by cesarean section and an increased risk of asthma admission. Based on this finding, we cannot conclude that there is an association between being born by cesarean section and a higher risk of suffering from asthma, unlike what has been postulated in other research studies.

Abstract 68 | PDF Downloads 109 HTML Downloads 0 XML Downloads 3

References

1. Pavord ID, Beasley R, Agusti A, Anderson GP, Bel E, Brusselle G, et al. After asthma: redefining airways diseases. Lancet. 2018;391:350–400. 10.1016/S0140-6736(17)30879-6

2. Moral Gil L, Asensi Monzó M, Juliá Benito JC, Ortega Casanueva C, Paniagua Calzón NM, Pérez García MI et al. Asma en pediatría. Consenso regAp. Alicante (España): Luis Moral; 2021. [Revisión]. Available in: https://www.seicap.es/asma-en-pediatr%C3%ADa-consenso-regap-2021_94549.pdf (Accessed: October 10, 2021)

3. Organización Mundial de la Salud. https://www.who.int/-features/factfiles/asthma/en/ (Accessed: March 03, 2020).

4. Sobradillo P, Miravitlles M, Jiménez CA, Gabriel R, Viejo JL, Masa JF et al. Estudio IBERPOC en España: prevalencia de síntomas respiratorios habituales y de limitación crónica al flujo aéreo. Arch Bronconeumol. 1999;35:159–66. 10.1016/S0300-2896(15)30272-6

5. García-Marcos L, Quirós AB, Hernández GG, Guillén-Grima F, Díaz CG, Ureña IC, et al. Stabilization of asthma prevalence among adolescents and increase among schoolchildren (ISAAC phases I and III) in Spain. Allergy. 2004;59(12):1301–7. 10.1111/j.1398-9995.2004.00562.x

6. Lundbäck B, Backman H, Lötvall J, Rönmark E. Is asthma prevalence still increasing? Expert Rev Respir Med. 2016;10(1):39–51. 10.1586/17476348.2016.1114417

7. Plaza Moral, Vicente, Almoacid Sánchez C, Álvarez Gutiérrez FJ, De arriba Méndez S, Barros Monge M, Bergna MA et al. GEMA5.0. Guía española para el manejo del asma. Sociedad Española de Neumología y Cirugía Torácica. Realización: Luzán 5 Health Consulting, S.A. ISBN: 978-84-17372-97-2. Depósito Legal: M-11218-2020. Consultado el 25/05/2020.

8. Bercedo A, Redondo C, Lastra L, Gómez M, Mora E, Pacheco M, et al. Prevalencia de asma bronquial, rinitis alérgica y dermatitis atópica en adolescentes de 13–14 años de Cantabria. Bol. Pediatr. 2004;44 (187):9–19.

9. Augusto A Litonjua, et al. (2020). Epidemiology of asthma. En UpToDate. SEction Editor Peter J Barnes. Deputy Editor Helen Hollingsworth. Available at https://www.uptodate.com/contents/epidemiology-of-asthma?search=prevalencia%20asma%202020§ionRank=1&usage_type=default&anchor=H3631798105&source=machineLearning&selectedTitle=1~150&display_rank=1#H5 (Accessed: October 9, 2021)

10. Burr ML. Asthma prevalence in 1973, 1988, and 2003. Thorax 2006; 61:296–9.

11. Pellegrini Belinchón J et al. Grupo de trabajo de asma y alergia de la SEPEAP. Editorial. El asma es la enfermedad crónica más prevalente en Pediatría. La Task Force European Respiratory Society, recomienda a estas edades la denominación de Sibilancias Recurrentes en lugar de asma. Pediatría Integral. Vol. XVIII, n° 5, junio 2014. Curso V. Available at https://www.pediatriaintegral.es/publicacion-2014-06/grupo--de-trabajo-de-asma-y-alergia-de-la-sepeap/ (Accessed: October 17, 2021)

12. Adams M, Doull I. Birth by caesarean section and asthma. Clin Exp Allergy. 2008;38(4):554-556. 10.1111/j.1365-2222.2008.02948.x

13. Bjorksten B, Sepp E, Julge K, Voor T, Mikelsaar M. Allergy development and the intestinal microflora during the first year of life. J Allergy Clin Immunol 2001;108:516–20. 10.1067/mai.2001.118130.

14. Menacker F, Declercq E, Macdorman MF. Caesarean delivery: background, trends, and epidemiology. Semin Perinatol 2006;30:235–41. 10.1053/j.semperi.2006.07.002

15. Thavagnanam S, Fleming J, Bromley A, Shields MD, Cardwell CR. A meta-analysis of the association between Caesarean section and childhood asthma. Clin Exp Allergy 2008;38:629–33. 10.1111/j.1365-2222.2007.02780.x

16. Saavedra José M. Probióticos, inmunidad y salud en pediatría. Gaceta Médica de México. 2011;147 Suppl 1:9–21.

17. Mikael Kuitunen MD, et al. Probiotics prevent IgE-associated allergy until age 5 years in cesarean-delivered children but not in the total cohort. J Allergy Clin Immunol. 2009;123(2):335–41. 10.1016/j.jaci.2008.11.019

18. Betrán A.P. et al. Rates of caesarean section: analysis of global, regional and national estimates. Paediatr Perinat Epidemiol. 2007,21:98–113. 10.1111/j.1365-3016.2007.00786.x

19. Laura Keenan et al. Caesarean section rates continue to rise, amid growing inequalities in Access. Available at: https://www.who.int/news/item/16-06-2021-caesarean-section-rates-continue-to-rise-amid-growing-inequalities-in-access. (Accessed: December 6, 2021)

20. Births by caesarean section. Data by country. Available at https://apps.who.int/gho/data/node.main.BIRTHSBYCAESAREAN?lang=en (Accessed: December 6, 2021).