Background Clinical studies have shown prematurity, birth via caesarean section (CS) and exposure to breastmilk impact the establishment of gut microbiota and immune system in early life and increase susceptibility to acute gut infections. This study aims to investigate the combined association of mode, timing of birth and breastfeeding with acute gastroenteritis (AGE) in early childhood.
Method We conducted a population-based cohort study of 893,360 infants born in New South Wales, Australia, 2001–2011. Data was ascertained via record-linkage of administrative birth, hospital and death data. Follow-up was based on time between discharge at birth to first admission of AGE, sixth birthday, death or study end-date (30/06/2012). Multivariable Cox regression was used to estimate risk of AGE admission adjusted for maternal, obstetric and birth factors.
Results In 2001–2011, there were 41,274 (4.6%) hospital admissions for AGE in childhood; two-thirds admitted.
Conclusion Findings support the biological hypothesis of the importance of mode, timing of birth and breastfeeding in development of gut microbiota and immune system in early life. Spontaneous vaginal birth at 39+ weeks gestation with any exposure to breastmilk at birth minimises the risk of AGE hospital admission in early childhood.