Cesarean Section and Development of Childhood Bronchial Asthma: Is There A Risk?

BACKGROUND: Asthma is a chronic inflammatory disease of the airways that results from complex interactions between multiple environmental and genetic influences. In recent years, studies have observed an increase in caesarean section rates, and have suggested a strong association with the rapid increase in the incidence of childhood asthma that cannot be explained by genetic factors alone. In this case-control study, we investigate the association between the developments of childhood asthma with the mode of delivery. We also explored the relationship between mode of delivery and control of asthma. METHODS: Two groups (509 pediatric patients in total) were assessed between January 1, 2017, and January 1, 2018. Part of these patients, 257 (50.4%) were asthmatic children visiting specialised clinics, and 252 (49.6%) controlled cases selected from a primary health care clinic from the same institution (control group). RESULTS: The Chi-square test revealed a significant association between cesarean sections and bronchial asthma (OR, 1.483 [95% CI, 1.013–21.71]; P =0.042). However, the adjusted OR from our binary logistic regression model revealed this association to be insignificant (adjusted OR, 1.417 [95% CI, 0.885–2.269]; P =0.804). The value of the chi-square of the model shows that the overall model is statistically significant at 1%. The Nagelkerke R square indicates that 34.9% of the variation in having asthma is explained by the risk factors included in the model. CONCLUSION: We do not believe that the rise in cesarean sections explains the increase in childhood bronchial asthma – at least not in our population. We also found no association between the mode of delivery and asthma control. We encourage further research into this topic, namely to recruit a larger number of patients, and to adjust for the significant risk factors found in our study.