Individuals born via cesarean section are likely to develop Crohn’s disease later on in life, suggests a new research published in Acta Obstetricia et Gynecologica Scandinavica.¹

In this study from Sweden, individuals who had been born full-term between 1990 and 2000 were analysed to explore an association between cesarean section and risk of gastrointestinal disease later on in life. Data was obtained from the Swedish Medical Birth Register. The study subjects were followed up until 2017 with regards to the outcomes: inflammatory bowel disease (Crohns disease or ulcerative colitis), appendicitis, cholecystitis, or diverticulitis registered in the Swedish National Patient Register.

Out of the 1,102,468 participants included in the study, 88.4% were vaginally delivered and the remaining 11.6% were cesarean births. Of these, the majority were emergency procedures (56.2%), while the 43.8% were elective.

Cesarean section was found to be associated with increased risk of Crohns disease both on univariate and multivariate analyses with hazard ratio of 1.13 and 1.18, respectively compared to vaginal deliveries. The risk of diverticulosis (HR 1.57) and cholecystitis (HR 1.16) was also found to be linked to cesarean delivery on univariate analysis. But on multivariate analysis, after adjusting for factors such as birth weight, gestational age, being small for gestational age, perinatal illness, congenital malformations, maternal smoking, and highest parental education, these associations were non-significant and only the risk for Crohn’s disease was found to persist with HR 1.14. No such correlation was noted between the type of delivery and appendicitis, ulcerative colitis, cholecystitis or diverticulosis.

This study sheds light on probable long-term impact of cesarean birth on an individual as shown by the association between elective (and not emergency) cesarean section and future Crohn’s disease.

Reference

1. Hellsing C, et al. Delivery mode and risk of gastrointestinal disease in the offspring. Acta Obstet Gynecol Scand. 2022 Aug 4. doi: 10.1111/aogs.1442.