Cesarean delivery associated with substantial risk of Crohn's disease

A recent study found that caesarean births increase the risk of developing Crohn's disease later in life. The study was published in the journal 'Acta Obstetricia et Gynecologica Scandinavica'. 

Cesarean deliveries make up around 20% of all deliveries and are on an increasing trend. Researchers from Sweden conducted a study to evaluate the increased risk of gastrointestinal disease in cesarean births and also to know if they are associated with any other subsequent diseases associated later in life. 

A large national-level population-based cohort study was conducted on all full-term individuals registered in the Medical Birth Register in Sweden between 1990 and 2000. The mode of delivery was collected from the Medical Birth Register. As per the Swedish National Patient Register, outcomes like inflammatory bowel disease (Crohn's disease or ulcerative colitis), appendicitis, cholecystitis, or diverticulitis were observed in the study population until 2017. Cox proportional-hazards models compared disease-free survival time between exposed and unexposed. 

Results

Around 11,02,468 individuals participated in the study of whom 11.6% were delivered by cesarean section and 88.4% were vaginally delivered.

Cesarean section was associated with Crohn's disease, diverticulosis, and cholecystitis in univariate analysis.

After adjustment for confounders, the increased risk only remained for Crohn's disease.

In the multivariate analysis, no associations between delivery mode and appendicitis, ulcerative colitis, cholecystitis, or diverticulosis were found. 

Thus, it was concluded from the study that Cesarean section is associated with Crohn's disease later in life and no other association was found between delivery mode and gastrointestinal disorders later in life. 

To read the full article, click here:  https://doi.org/10.1111/aogs.14427 

Hellsing C, Örtqvist AK, Hagel E, Mesas-Burgos C, Gustafsson UO, Granström AL. Delivery mode and risk of gastrointestinal disease in the offspring [published online ahead of print, 2022 Aug 4]. Acta Obstet Gynecol Scand. 2022;10.1111/aogs.14427.