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Caesarean Section o...
Caesarean Section on The Risk of Celiac Disease in the Offspring : The Teddy Study
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- Koletzko, Sibylle (author)
- University Hospital Munich
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- Lee, Hye-Seung (author)
- University of South Florida
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- Beyerlein, Andreas (author)
- Technical University of Munich
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- Aronsson, Carin A. (author)
- Lund University,Lunds universitet,Celiaki och diabetes,Forskargrupper vid Lunds universitet,Celiac Disease and Diabetes Unit,Lund University Research Groups
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- Hummel, Michael (author)
- Technical University of Munich
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- Liu, Edwin (author)
- University of Colorado
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- Simell, Ville (author)
- University of Turku
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- Kurppa, Kalle (author)
- University of Tampere
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- Lernmark, Åke (author)
- Lund University,Lunds universitet,Celiaki och diabetes,Forskargrupper vid Lunds universitet,Celiac Disease and Diabetes Unit,Lund University Research Groups
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- Hagopian, William (author)
- Pacific Northwest Research Institute
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- Rewers, Marian (author)
- Technical University of Munich
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- She, Jin-Xiong (author)
- Medical College of Georgia
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- Simell, Olli (author)
- University of Turku,Turku University Hospital
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- Toppari, Jorma (author)
- Turku University Hospital,University of Turku
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- Ziegler, Anette G. (author)
- University of Colorado
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- Krischer, Jeffrey (author)
- University of South Florida
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- Agardh, Daniel (author)
- Lund University,Lunds universitet,Celiaki och diabetes,Forskargrupper vid Lunds universitet,Celiac Disease and Diabetes Unit,Lund University Research Groups
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(creator_code:org_t)
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- 2018
- 2018
- English.
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In: Journal of Pediatric Gastroenterology and Nutrition. - 0277-2116. ; 66:3, s. 417-424
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http://dx.doi.org/10...
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Abstract
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- OBJECTIVE:: Caesarean section (C-section) is associated with various immune-mediated diseases in the offspring. We investigated the relationship between mode of delivery and celiac disease (CD) and CD autoimmunity (CDA) in a multinational birth cohort. METHODS:: From 2004 to 2010 infants from the general population who tested positive for HLA DR3-DQ2 or DR4-DQ8 were enrolled in The Environmental Determinants for Diabetes in the Young (TEDDY) study. Children were annually screened for transglutaminase autoantibodies, if positive re-tested after 3–6 months and those persistently positive defined as CDA. Associations of C-section with maternal (age, education level, parity, pre-pregnancy weight, diabetes, smoking, weight gain during pregnancy) and child characteristics (gestational age, birth weight) were examined by Fisherʼs exact test or Wilcoxon rank-sum test. Hazard ratios (HRs) for CDA or CD were calculated by Cox proportional hazard regression models. RESULTS:: Of 6,087 analyzed singletons 1600 (26%) were born by C-section (Germany 38%, US 37%, Finland 18%, Sweden 16%), the remaining vaginally without instrumental support; 979 (16%) had developed CDA and 343 (6%) CD. C-section was associated with lower risk for CDA (HR?=?0.85, [95% CI 0.73, 0.99], p?=?0.032) and CD (HR?=?0.75, [95% CI 0.58, 0.98], p?=?0.034). After adjusting for country, sex, HLA-genotype, CD in family, maternal education and breastfeeding duration, significance was lost for CDA (HR?=?0.91, [95% CI 0.78, 1.06], p?=?0.20) and CD (HR?=?0.85, [95% CI 0.65, 1.11], p?=?0.24). Pre-surgical ruptured membranes had no influence on CDA or CD development. CONCLUSION:: C-section is not associated with increased risk for CDA or CD in the offspring.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Pediatrik (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Pediatrics (hsv//eng)
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- By the author/editor
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Koletzko, Sibyll ...
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Lee, Hye-Seung
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Beyerlein, Andre ...
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Aronsson, Carin ...
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Hummel, Michael
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Liu, Edwin
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show more...
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Simell, Ville
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Kurppa, Kalle
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Lernmark, Åke
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Hagopian, Willia ...
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Rewers, Marian
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She, Jin-Xiong
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Simell, Olli
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Toppari, Jorma
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Ziegler, Anette ...
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Krischer, Jeffre ...
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Agardh, Daniel
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show less...
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Pediatrics
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Lund University