Caesarean section and gastrointestinal symptoms, atopic dermatitis, and sensitisation during the first year of life

Laubereau, B; Filipiak-Pittroff, B; von Berg, A; Grübl, A; Reinhardt, D; Wichmann, H E; Koletzko, S

doi:10.1136/adc.2003.043265

Caesarean section and gastrointestinal symptoms, atopic dermatitis, and sensitisation during the first year of life

¹GSF-National Research Centre for Environment and Health, Institute of Epidemiology, Neuherberg, Germany
²Marien-Hospital Wesel, Department of Pediatrics, Wesel, Germany
³Technical University of Munich, Department of Pediatrics, Munich, Germany
⁴Ludwig-Maximilians-University, Department of Pediatrics, Munich, Germany

Correspondence to:
Dr S Koletzko
Kinderklinik & Kinderpoliklinik Dr. v. Haunersches Kinderspital, Ludwig-Maximilians-University Munich, Lindwurmstr. 4 D-80337 Munich, Germany; sibylle.koletzkomed.uni-muenchen.de

Accepted 2 February 2004

Abstract

Aims: To investigate the effect of caesarean section on gastrointestinal symptoms, atopic dermatitis, and sensitisation to nutritional allergens in infants.

Methods: A total of 865 healthy full term neonates with parental history of allergy participating in the prospective German Infant Nutritional Intervention Program (GINI) were exclusively breast fed during the first four months of life and had a one year follow up. Data were obtained by follow up visits at age 1, 4, 8, and 12 months, weekly diaries for the first six months, and measurement of total and specific IgE at birth and 12 months.

Results: Infants born by caesarean section (147/865, 17%) had a greater risk of diarrhoea (OR_adj 1.46, 95% CI 1.022 to 2.10) and sensitisation to food allergens, both in adjusted (OR_adj 2.06, 95% CI 1.123 to 3.80) and stratified analyses (by cord blood IgE). Caesarean delivery was not associated with colicky pain and atopic dermatitis.

Conclusion: Caesarean delivery might be a risk factor for diarrhoea and sensitisation in infants with family history of allergy. Further research in this area seems warranted as choosing caesarean section becomes increasingly popular.

Footnotes

Gini Study Group: Wesel: D Berdel, A von Berg, B Albrecht, A Baumgart, Ch Bollrath, S Büttner, S Diekamp, T Jakob, K Klemke, S Kurpiun, T Müller-Wening, A Varhelyi, C Zorn; LMU Munich: D Reinhardt, S Koletzko, B Bäumler-Merl, R Göhlert, I Jesch, M Koch, T Sauerwald, C Sönnichsen, C Tasch, M Waag, H Weigand, D Mühlbauer; TU Munich: CP Bauer, A Grübl, P Bartels, I Brockow, A Fischer, U Hoffmann, R Mayrl, K Negele, E-M Schill, B Wolf; GSF Institute for Epidemiology Neuherberg: HE Wichmann, A Schoetzau, M Engl, B Filipiak-Pittroff, K Franke, U Gehring, K Honig-Blum, G Kruse, M Popescu, A Sindl, A Zirngibl
The GINI study (German Infant Nutritional Intervention Study) was supported by the Federal Ministry for Education, Science, Research and Technology, Grant No. 01 EE 94014. The data analysis of this study was supported by Institute Danone Foundation and the Child Health Foundation (“Stiftung Kindergesundheit”).