Results
The jecs-an-20180131 dataset
contained information about 104,065 fetuses and 98,255 live singleton
births. After applying the study’s inclusion criteria, 74,639 subjects
were eligible to participate in this study (Fig. 1).
Of the 74,639 mothers, 13,756
(18.4%) and 60,883 (81.6%) underwent cesarean and vaginal delivery,
respectively. Of the 13,756 cesarean deliveries, 8,057 (10.8%) and
5,699 (7.6%) were elective and emergency cesarean deliveries,
respectively. Table 1 presents the participants’ characteristics. A
higher incidence of cesarean delivery was associated with a maternal age
at pregnancy ≥ 30 years, parity ≥ 2, GA < 39 weeks, SGA,
maternal smoking during pregnancy, higher maternal education, higher
annual family income, and pet ownership.
A lower incidence of cesarean
delivery was associated with primipara and breastfeeding at six months.
The rates of asthma, atopic dermatitis, wheezing, and eczema in those
born via cesarean delivery were 2.7%, 4.2%, 20.2%, and 18.1%,
respectively; while the rates for those born via vaginal delivery were
2.5%, 4.4%, 19.5%, and 19.0%, respectively. There were differences
noted in the rate of eczema between the cesarean and vaginal delivery
groups, while there were no differences in the rates of asthma, atopic
dermatitis, and wheezing.
Multiple logistic regression was performed to assess the risks of
asthma, atopic dermatitis, wheezing, and eczema associated with cesarean
delivery (Table 2). After adjusting for perinatal and socioeconomic
confounding factors, cesarean delivery was not associated with an
increased risk of asthma [adjusted ORs (aOR) = 0.97; 95% CI,
0.85–1.10], atopic dermatitis (aOR = 1.02; 95% CI, 0.92–1.13),
wheezing (aOR = 0.99; 95% CI, 0.94–1.04), or eczema (aOR = 0.99; 95%
CI, 0.94–1.04). After adjusting
for perinatal, socioeconomic, and postnatal confounding factors,
cesarean delivery was not associated with an increased risk of asthma
(aOR = 0.95; 95% CI, 0.84–1.08), atopic dermatitis (aOR = 1.02; 95%
CI, 0.92–1.13), wheezing (aOR = 0.98; 95% CI, 0.94–1.04), or eczema
(aOR = 0.99; 95% CI, 0.94–1.05). Overall crude ORs and aORs for the
association between elective and emergency cesarean delivery (vs.
vaginal delivery) and the risks of asthma, atopic dermatitis, wheezing,
and eczema are shown in Table 3. After adjusting for perinatal and
socioeconomic confounding factors, elective cesarean delivery was
associated with an increased risk of wheezing (aOR = 1.07; 95% CI,
1.01–1.13) and emergency cesarean delivery was associated with a
decreased risk of eczema (aOR = 0.90; 95% CI, 0.84–0.97). After
adjusting for perinatal, socioeconomic, and postnatal confounding
factors, emergency cesarean delivery was associated with a decreased
risk of eczema (aOR = 0.91; 95% CI, 0.84–0.97).