title: Caesarean section and asthma in Malaysian children: a case-control study.
abstract: BACKGROUND
  Birth cohort studies in some countries have shown a link between caesarean section and asthma.
  
  
  OBJECTIVE
  To determine if there is an association between asthma and delivery via caesarean section in Malaysian children.
  
  
  METHODS
  This is a case-control study involving 156 children aged 3-15 years old, in a tertiary hospital in Kuala Lumpur, Malaysia. Seventy-eight children with a confirmed diagnosis of asthma and seventy-eight age-matched controls (no history of asthma or wheezing) were enrolled. Demographic data including mode of delivery and family history of allergic disorders was obtained. Total serum immunoglobulin E (IgE) was measured and skin prick tests (SPT) to 6 common aeroallergens were performed.
  
  
  RESULTS
  The median age of the patients was 8 years old. One hundred and three (66%) children were delivered via normal vaginal delivery, 8 (5.1%) via assisted vaginal delivery and 45 children (28.9%) via caesarean section. Delivery via caesarean section was not significantly associated with asthma (OR = 1.21 [95% CI 0.60-2.41], p = 0.596). Children delivered via caesarean section did not have higher IgE levels nor were they more sensitized to aeroallergens. Multiple logistic regression showed that asthma was significantly associated with a positive family history of atopy (OR = 13.8 [95% CI 5.96, 32.1], p < 0.001). Introduction of semi-solid food after 6 months old had a protective effect against asthma (OR = 0.97 [95% CI 0.94, 0.99], p = 0.034).
  
  
  CONCLUSIONS
  Childhood asthma in Malaysian children was not associated with delivery by caesarean section.
authors.affiliation: Department of Paediatrics, University Malaya Medical Centre, Kuala Lumpur, Malaysia. psr9900@hotmail.com
authors.forename: Anna Marie
authors.initials: AM
authors.lastname: Nathan
authors.forename: Jessie
authors.initials: J
authors.lastname: de Bruyne
authors.forename: Farah
authors.initials: F
authors.lastname: Khalid
authors.forename: Kulantheran
authors.initials: K
authors.lastname: Arumugam
mesh_terms: D000293:Adolescent; D000485:Allergens / Q000276:immunology; D044466:Asian People; D001249:Asthma / Q000097:blood / Q000453:epidemiology* / Q000209:etiology / Q000276:immunology; D016022:Case-Control Studies; D002585:Cesarean Section / Q000009:adverse effects / Q000706:statistics & numerical data*; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood / Q000276:immunology; D008296:Malaysia / Q000453:epidemiology; D011247:Pregnancy; D012882:Skin Tests / Q000379:methods; D062606:Tertiary Care Centers
chemical_list: D000485:Allergens; D007073:Immunoglobulin E