Association Between Mode of Delivery and Risk of Infection in Early Childhood: A Cohort Study

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Resumé

Background: Infections are the leading cause of morbidity and mortality in children. Caesarean section as a potential risk factor for infection has recently gained interest. Delivery by caesarean section has increased greatly, with nonmedical reasons playing an increasing role. We aimed to analyze the association between mode of delivery and hospitalizations because of infection and symptoms of infection at home in early childhood. Methods: A cohort study, based on the Odense Child Cohort, following infants from gestation until a mean age of 3.5 years. Data on hospitalization because of infections were collected from the Danish National Patient Registry. Data on symptoms of infection at home were collected via a text message-based questionnaire. Results: A total of 1921 children were born by vaginal delivery, 283 by elective caesarean section and 227 by acute caesarean section. An adjusted regression model showed an incidence rate ratio for hospitalizations because of infection in children born by elective caesarean section compared with children born by vaginal delivery of 1.45 (95% confidence interval: 1.16-1.80; P = 0.001). The analyses on symptoms of infection at home found no associations between any symptom of infection and mode of delivery. Symptom-specific subanalyses showed contrasting results. Conclusions: Mode of delivery showed a strong association to hospitalization because of infectious disease during early childhood. Overall, no association was present between rate of symptoms of infection at home and mode of delivery.

OriginalsprogEngelsk
TidsskriftPediatric Infectious Disease Journal
Vol/bind37
Udgave nummer4
Sider (fra-til)316-323
ISSN0891-3668
DOI
StatusUdgivet - apr. 2018

Fingeraftryk

Cohort Studies
Text Messaging
Child Mortality
Registries
Confidence Intervals
Incidence

Citer dette

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title = "Association Between Mode of Delivery and Risk of Infection in Early Childhood: A Cohort Study",
abstract = "Background: Infections are the leading cause of morbidity and mortality in children. Caesarean section as a potential risk factor for infection has recently gained interest. Delivery by caesarean section has increased greatly, with nonmedical reasons playing an increasing role. We aimed to analyze the association between mode of delivery and hospitalizations because of infection and symptoms of infection at home in early childhood. Methods: A cohort study, based on the Odense Child Cohort, following infants from gestation until a mean age of 3.5 years. Data on hospitalization because of infections were collected from the Danish National Patient Registry. Data on symptoms of infection at home were collected via a text message-based questionnaire. Results: A total of 1921 children were born by vaginal delivery, 283 by elective caesarean section and 227 by acute caesarean section. An adjusted regression model showed an incidence rate ratio for hospitalizations because of infection in children born by elective caesarean section compared with children born by vaginal delivery of 1.45 (95{\%} confidence interval: 1.16-1.80; P = 0.001). The analyses on symptoms of infection at home found no associations between any symptom of infection and mode of delivery. Symptom-specific subanalyses showed contrasting results. Conclusions: Mode of delivery showed a strong association to hospitalization because of infectious disease during early childhood. Overall, no association was present between rate of symptoms of infection at home and mode of delivery.",
keywords = "Cesarean Section/adverse effects, Child, Preschool, Communicable Diseases/epidemiology, Denmark/epidemiology, Female, Hospitalization, Humans, Incidence, Infant, Infant, Newborn, Male, Pregnancy, Prospective Studies, Risk Assessment, Surveys and Questionnaires",
author = "Nikolas Christensen and Jens S{\o}ndergaard and Christesen, {Henrik Thybo} and Niels Fisker and Steffen Husby",
year = "2018",
month = "4",
doi = "10.1097/INF.0000000000001778",
language = "English",
volume = "37",
pages = "316--323",
journal = "Pediatric Infectious Disease Journal",
issn = "0891-3668",
publisher = "Lippincott Williams & Wilkins",
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}

TY - JOUR

T1 - Association Between Mode of Delivery and Risk of Infection in Early Childhood

T2 - A Cohort Study

AU - Christensen, Nikolas

AU - Søndergaard, Jens

AU - Christesen, Henrik Thybo

AU - Fisker, Niels

AU - Husby, Steffen

PY - 2018/4

Y1 - 2018/4

N2 - Background: Infections are the leading cause of morbidity and mortality in children. Caesarean section as a potential risk factor for infection has recently gained interest. Delivery by caesarean section has increased greatly, with nonmedical reasons playing an increasing role. We aimed to analyze the association between mode of delivery and hospitalizations because of infection and symptoms of infection at home in early childhood. Methods: A cohort study, based on the Odense Child Cohort, following infants from gestation until a mean age of 3.5 years. Data on hospitalization because of infections were collected from the Danish National Patient Registry. Data on symptoms of infection at home were collected via a text message-based questionnaire. Results: A total of 1921 children were born by vaginal delivery, 283 by elective caesarean section and 227 by acute caesarean section. An adjusted regression model showed an incidence rate ratio for hospitalizations because of infection in children born by elective caesarean section compared with children born by vaginal delivery of 1.45 (95% confidence interval: 1.16-1.80; P = 0.001). The analyses on symptoms of infection at home found no associations between any symptom of infection and mode of delivery. Symptom-specific subanalyses showed contrasting results. Conclusions: Mode of delivery showed a strong association to hospitalization because of infectious disease during early childhood. Overall, no association was present between rate of symptoms of infection at home and mode of delivery.

AB - Background: Infections are the leading cause of morbidity and mortality in children. Caesarean section as a potential risk factor for infection has recently gained interest. Delivery by caesarean section has increased greatly, with nonmedical reasons playing an increasing role. We aimed to analyze the association between mode of delivery and hospitalizations because of infection and symptoms of infection at home in early childhood. Methods: A cohort study, based on the Odense Child Cohort, following infants from gestation until a mean age of 3.5 years. Data on hospitalization because of infections were collected from the Danish National Patient Registry. Data on symptoms of infection at home were collected via a text message-based questionnaire. Results: A total of 1921 children were born by vaginal delivery, 283 by elective caesarean section and 227 by acute caesarean section. An adjusted regression model showed an incidence rate ratio for hospitalizations because of infection in children born by elective caesarean section compared with children born by vaginal delivery of 1.45 (95% confidence interval: 1.16-1.80; P = 0.001). The analyses on symptoms of infection at home found no associations between any symptom of infection and mode of delivery. Symptom-specific subanalyses showed contrasting results. Conclusions: Mode of delivery showed a strong association to hospitalization because of infectious disease during early childhood. Overall, no association was present between rate of symptoms of infection at home and mode of delivery.

KW - Cesarean Section/adverse effects

KW - Child, Preschool

KW - Communicable Diseases/epidemiology

KW - Denmark/epidemiology

KW - Female

KW - Hospitalization

KW - Humans

KW - Incidence

KW - Infant

KW - Infant, Newborn

KW - Male

KW - Pregnancy

KW - Prospective Studies

KW - Risk Assessment

KW - Surveys and Questionnaires

U2 - 10.1097/INF.0000000000001778

DO - 10.1097/INF.0000000000001778

M3 - Journal article

C2 - 28885459

VL - 37

SP - 316

EP - 323

JO - Pediatric Infectious Disease Journal

JF - Pediatric Infectious Disease Journal

SN - 0891-3668

IS - 4

ER -