Abstract
BackgroundPrevious studies have found a relationship between cesarean section delivery and adverse outcomes in the offspring, partially attributing these findings to differential development of immunity in infants delivered by cesarean compared to vaginal delivery. The purpose of this study is to determine whether cesarean section delivery is associated with higher reports of adverse short-term infant health outcomes in a peri-urban Indian population.MethodsData from a prospective pregnancy cohort study in a peri-urban region of Telangana State, India, were analyzed to assess the association between mode of delivery, cesarean section or vaginal, and maternal report of recent infant diarrhea and/or respiratory symptoms at a 6 month follow-up visit. Inverse probability weights were applied to log-binomial regression models to account for maternal pre-pregnancy, prenatal, and labor and delivery factors.ResultsOf the 851 singleton infants delivered between 2010 and 2015, 46.7% were delivered by cesarean. Cesarean delivery was not associated with an increased report of infants having one or more of the outcomes (diarrhea, respiratory infection, or difficulty breathing) at 6 months (adjusted risk ratio 0.89, 95% confidence interval 0.76–1.03), nor was it associated with infants having a more severe outcome of comorbid diarrhea and respiratory infection (adjusted risk ratio 1.08, 95% confidence interval 0.58–2.04).ConclusionUnlike findings in Western populations, in this peri-urban Indian population, cesarean delivery was not associated with higher reports of short-term adverse gastrointestinal or respiratory infant outcomes after accounting for pre-delivery maternal factors. Future research in this cohort could elucidate whether mode of delivery is associated with other adverse outcomes later in childhood.
Highlights
Previous studies have found a relationship between cesarean section delivery and adverse outcomes in the offspring, partially attributing these findings to differential development of immunity in infants delivered by cesarean compared to vaginal delivery
The purpose of this study is to identify whether infants in a peri-urban Indian population delivered by cesarean have higher reports of gastrointestinal, or respiratory health problems at 6 months compared to infants delivered vaginally
There were no significant differences in infant sex, gestational age, birth weight, weight at 6 months, or infant age at the time of questionnaire, a higher proportion of girls had comorbid diarrhea and respiratory infection as compared to boys (p = 0.06)
Summary
Previous studies have found a relationship between cesarean section delivery and adverse outcomes in the offspring, partially attributing these findings to differential development of immunity in infants delivered by cesarean compared to vaginal delivery. Diarrhea and acute respiratory infections are among the leading preventable causes of mortality worldwide in children under age five years old, in low and middle income countries [1] Risk factors for these conditions include malnutrition, lack of breastfeeding, contaminated drinking water, and poor sanitation and hygiene practices [1]. Gondwe et al BMC Pediatrics (2018) 18:346 at birth, but instead are first exposed to microbes of the mother’s skin and the birth environment [3, 4] This is thought to negatively impact the composition of the infant’s intestinal microbiome, impeding the development of a healthy immune system, and possibly leading to later adverse health outcomes [3, 4]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
