Cesarean section and the risk of allergic rhinitis in children: A systematic review and meta-analysis

Abstract

Abstract Background Multiple evidence indicates that perinatal factors make impact on immune development and affect offspring allergic rhinitis(AR) risk. In this systematic review and meta-analysis, we examined available published studies to clarify the relationship between cesarean section(C-section) and offspring AR in children. Objective To explore the relationship between C-section, especially the special attention was paid to different cesarean delivery method, and the risk of AR in children. Methods Articles were searched using PubMed, Web of Science, EMBASE, Cochrane Library, China knowledge Network, Wanfang, and China Science and Technology Journal databases. A meta-analysis of 22 studies published before August 1, 2022, which included 1,464,868 participants, was conducted for statistical analysis with RevMan5.4. The correlation strength between C-section and offspring AR was determined by combining odds ratio(OR) and 95% confidence interval(95%CI). Publication bias was detected using the funnel chart and Begg’s tests. Results Meta-analysis revealed that there was a significant correlation between C-section and children AR (OR = 1.19, 95% CI:1.12–1.27, P < 0.001), especially C-section with a family history of allergy (OR = 1.82, 95%CI:1.36–2.43, P < 0.001). Moreover, elective C-section (without genital tract microbe exposure) had the higher risk of offspring AR (OR = 1.24, 95%CI:1.05–1.46, P = 0.010) compared with the whole study. Conclusions Delivery by C-section, particularly elective C-section and C-section with a family history of allergy can increase the risk of AR in children.