Master's Project Title:

Does Cesarean Section Increase the Risk of Child Asthma? A systematic review

MCH Student:

Mark Sloan

Date of Defense:

May 27, 2015

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Background: Asthma, the most common chronic childhood inflammatory condition, is a  disease with far – reaching public health impact. The prevalence of child asthma has risen  dramatically in the last half – century. During the same time period the U.S. cesarean section rat e  has risen nearly six – fold, leading some researchers to postulate a connection between the two.  The purpose of this systematic review is to examine the evidence both for and against an  association between cesarean section and child asthma.  Methods: A li terature search was performed through the University of Minnesota library  website. Search terms included (“cesarean section” AND “child” AND “asthma”) and (“cesarean  section” AND “child” AND “mode of delivery”), with secondary searches of the reference lis ts  of retrieved articles. Quality of articles was determined using the United States Preventive  Services Task Force “Hierarchy of research design and quality rating criteria.”  Results: The search strategy returned 127 articles. After elimination of dupli cate and clearly  irrelevant articles, 29 observational studies and 3 meta – analyses were selected. Methodological  problems were common: only 9 studies adjusted for all of the most important confounders. Of  the 6 articles chosen for final analysis, 4 detecte d a  significant association between cesarean  section and child asthma.  Conclusion: D espite significant methodological issues, the preponderance of available research  evidence supports a small – to – moderate association between cesarean section and child asthma.  While further research is needed, efforts to reduce unnecessary cesarean births n ow could lead to  a small but significant reduction in asthma morbidity in the United States.