Health care consequences of cesarean birth during the first 18 months of life.
OBJECTIVE
Elective cesarean delivery is increasingly common. The potential effects of surgical delivery in an unselected sample of infants beyond the immediate neonatal period remain poorly defined.


METHODS
We carried out an 18-month follow-up of a population-based cohort of 8327 Hong Kong Chinese infants born in 1997. The main outcome measures were utilization of outpatient visits and hospitalizations, categorized by doctor-diagnosed causes as reported by parents.


RESULTS
Among term singleton infants, there was no association of cesarean (compared with vaginal) birth with subsequent hospital admission (adjusted odds ratio = 0.92; 95% confidence interval = 0.79-1.08) or with above versus below the median number of outpatient episodes (1.10; 0.96-1.26) in the first 18 months of life. There were weak positive associations with afebrile gastrointestinal, respiratory, skin and a few other conditions.


CONCLUSIONS
Cesarean birth is not associated with hospitalization or outpatient care overall during the first 18 months after adjustment for confounders. We cannot rule out isolated associations with minor morbidities.
Leung
Gabriel M
GM
Department of Community Medicine and School of Public Health, The University of Hong Kong, Hong Kong, China. gmleung@hku.hk
Ho
Lai-Ming
LM
Tin
Keith Y K
KY
Schooling
C Mary
CM
Lam
Tai-Hing
TH
D000553:Ambulatory Care / Q000706:statistics & numerical data*; D002585:Cesarean Section / Q000009:adverse effects*; D002662:Child Health Services / Q000706:statistics & numerical data; D015331:Cohort Studies; D017558:Elective Surgical Procedures; D005260:Female; D005500:Follow-Up Studies; D006306:Health Surveys; D006723:Hong Kong / Q000453:epidemiology; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009017:Morbidity; D016017:Odds Ratio; D011247:Pregnancy; D011446:Prospective Studies