Caesarean Birth Linked to Infection-related Hospitalisation in Early Childhood

Sarfaroj Khan 


November 26, 2020


  • Compared with vaginal birth, caesarean section (CS) was associated with an increased risk of infection-related hospitalisation in offspring up to 5 years of age.

  • Both elective and emergency CS births were associated with infection-related hospitalisation, with the highest increased risk following elective CS.

Why this matters

  • Findings may contribute to the global effort to reduce the rates of elective CS that are not medically indicated.

Study design

  • This multinational, population-based study included 7,174,787 recorded singleton live births between 1996 and 2015 using record-linked birth and hospitalisation data from Denmark, Scotland, England and Australia.

  • The risk of overall and clinical type of infection by mode of birth, vaginal or CS (emergency/elective), was estimated.

  • Funding: None disclosed.

Key results

  • Overall, 1,681,966 births were by CS, and of these, 727,755 were elective.

  • During follow-up, 1,502,537 (21%) children had ≥1 infection-related hospitalisation.

  • CS-born children vs vaginally born children were at a greater risk of infection-related hospitalisation (HR from random effects model, HR, 1.10, 95% CI, 1.09-1.12; P<.001).

  • Compared with vaginal birth, the risk was higher following both elective (HR, 1.13; 95% CI, 1.12-1.13) and emergency CS (HR, 1.09; 95% CI, 1.06-1.12; P<.001 for both).

  • Increased risks persisted to 5 years and were highest for respiratory, gastrointestinal and viral infections.

  • In the low-risk maternal subpopulation, the risk of infection-related hospitalisation in children born by CS was similar to overall findings (elective CS: HR, 1.14; 95% CI, 1.12-1.15; P<.001; emergency CS: HR, 1.08; 95% CI, 1.04-1.12; P<.001).


  • Site-specific and longitudinal variations in clinical practice.


Chaplin AB, Jones PB, Khandaker GM. Association between common early-childhood infection and subsequent depressive symptoms and psychotic experiences in adolescence: a population-based longitudinal birth cohort study. Psychol Med. 2020 Nov 13 [Epub ahead of print]. doi: 10.1017/S0033291720004080. PMID: 33183379 View abstract

This clinical summary originally appeared on Univadis, part of the Medscape Professional Network.


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