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JACI Highlights - July 2008
Birth by cesarean section, allergic rhinitis, and allergic sensitization among children with parental history of atopy
Michael Pistiner, MD, Diane R. Gold, MD, MPH, Hassen Abdulkerim, Ellaine Hoffman PhD, Juan C. Celedón, MD, DrPH
There has been much recent interest in allergic diseases such as atopic asthma, allergic rhinitis, and eczema because the incidence of these diseases continues to rise. Medical studies are focusing on identifying potential risk factors for these conditions. It is known that children born to parents who have a history of allergy or asthma are at increased risk for developing allergic diseases themselves. The relationship of the birth process to the prevalence of allergic disease has also been studied. C-section deliveries have been associated with babies' increased risk of asthma and/or allergic disease and it is known that without exposure to the mother's vaginal or gut flora there are long-lasting changes to the flora in the child's intestinal system, which may influence the development of the infant immune system. In a study published in the Journal of Allergy and Clinical Immunology, Pistiner et al studied the relationship between type of delivery and allergy and allergic diseases in 432 children whose parents had a history of allergies. The children were followed from birth to age 9 years and the authors found that those delivered by C-section were twice as likely to show allergic sensitization by school age as those born by vaginal delivery. Birth by C-section was significantly associated with increased odds of allergic rhinitis, although this study did not show a significant relationship between C-section and childhood asthma. The authors warn that a parental history of allergic disease combined with birth by C-section may pose a potential risk for children to develop allergic disease.
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