Abstract: Objective To examine the association between cesarean section (CS) and the risk of childhood asthma in preschool children. Methods A total of 8 900 children aged from 3 to 6 years old were recruited in Anqing,Wuhu,Tongling and Yangzhou.Data on the mode of delivery,asthma and potential confounders for the present study were obtained by questionnaires completed by the parents or the people who raised the children.All asthma cases were diagnosed by major hospitals.Mode of delivery was classified into vaginal delivery,elective CS and emergency CS.Multivariate logistic regression was used for statistical analyses. Results Of 8 900 preschool children,67.3% were born by cesarean section.The overall prevalence of asthma in the present cross-sectional study was 7.0%,within these children 28.5% were delivered vaginally while 71.5% were delivered by CS.After adjusting for region,sex,preterm birth,maternal age,parental education level,breastfeeding,child body mass index (BMI),children delivered by emergency CS had an increased risk of childhood asthma (OR=1.25,95%CI:1.03~1.52,P<0.05) compared to those delivered vaginally.However,no significant but elevated (OR=1.19,95%CI:0.94~1.51,P>0.05) higher odds of asthma was found in children delivered by elective CS compared to those delivered vaginally. Conclusion Emergency CS increased the risk of childhood asthma in preschool age.

Key words: asthma, cesarean section, children, preschool

摘要： 目的 分析剖宫产与学龄前儿童哮喘的关联,总结剖宫产与儿童哮喘的相关性,指导临床及孕产妇对剖宫产的认识。方法 选取安庆、芜湖、铜陵、扬州4个城市共8 900名3～6岁儿童作为研究对象。通过对儿童带养者问卷调查的形式收集儿童出生方式、哮喘患病情况、人口学资料和体格测量资料等。哮喘病例由县级以上医院确诊,孕妇分娩方式分为阴道分娩、医学指征剖宫产和选择剖宫产。运用多分类Logistic回归分析剖宫产与学龄前儿童哮喘的关联。结果 8 900名学龄前儿童中,剖宫产率为67.3%,哮喘患病率为7.0%,哮喘儿童中28.5%出生于自然分娩,71.5%出生于剖宫产。在控制地区、性别、早产、母亲怀孕年龄、父母文化程度、母乳喂养和儿童BMI后,医学指征剖宫产与学龄前儿童哮喘相关联(OR=1.25,95%CI1.03～1.52,P＜0.05),而选择性剖宫产与学龄前儿童哮喘的关联无统计学意义(OR=1.19,95%CI0.94～1.51,P＞0.05)。结论 剖宫产和学龄前儿童哮喘有关联,并且医学指征剖宫产会增加儿童哮喘发生的风险。

关键词: 哮喘, 剖宫产, 儿童, 学龄前