title: Caesarean Section has no impact on lung function at the age of 15 years.
abstract: BACKGROUND
  Epidemiological studies and meta-analyses have shown an increased risk of childhood asthma for children born by Caesarean Section (C-Section).
  
  
  OBJECTIVE
  To investigate the effect of delivery by C-Section on lung function and asthma in adolescence in a population-based prospective birth cohort of healthy full term newborns.
  
  
  METHODS
  Questionnaire data on mode of delivery and asthma as well as spirometric measurements were available for 1850 adolescents at the age of 15 years, who participated in a follow-up examination of the GINIplus study. Linear regression models were used to examine associations between mode of delivery and lung function parameters. Two reference populations (Lunokid and GLI) were used to calculate the standardized z-scores of lung function parameters.
  
  
  RESULTS
  The mean difference in lung function parameters for adolescents born by C-Section, compared to vaginal delivery was not statistically significant. The risk for developing asthma by the age of 15 years was not higher in children born by C-Section-OR: 0.87 (95% CI: 0.57, 1.33) adjusted for sex, age, study center, and parental education level.
  
  
  CONCLUSIONS
  C-Section was not associated with impaired lung function or an increased risk of asthma at the age of 15 years in our birth cohort of healthy full term neonates.
authors.affiliation: Institute of Epidemiology I, Helmholtz Zentrum München-German Research Center for Environment Health, Neuherberg, Germany.
authors.forename: Irene
authors.initials: I
authors.lastname: Brüske
authors.affiliation: Institute of Epidemiology I, Helmholtz Zentrum München-German Research Center for Environment Health, Neuherberg, Germany.|Faculty of Medicine, Ludwig-Maximilians-University of Munich, Munich, Germany.
authors.forename: Zhengcun
authors.initials: Z
authors.lastname: Pei
authors.affiliation: Institute of Epidemiology I, Helmholtz Zentrum München-German Research Center for Environment Health, Neuherberg, Germany.|Division of Metabolic and Nutritional Medicine, Dr. von Hauner Children's Hospital, University of Munich Medical Center, Munich, Germany.
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Thiering
authors.affiliation: Institute of Epidemiology I, Helmholtz Zentrum München-German Research Center for Environment Health, Neuherberg, Germany.
authors.forename: Claudia
authors.initials: C
authors.lastname: Flexeder
authors.affiliation: Department of Pediatrics, Marienhospital, Wesel, Germany.
authors.forename: Dietrich
authors.initials: D
authors.lastname: Berdel
authors.affiliation: Department of Pediatrics, Marienhospital, Wesel, Germany.
authors.forename: Andrea
authors.initials: A
authors.lastname: von Berg
authors.affiliation: Dr. von Hauner Children's Hospital, Ludwig-Maximilians University of Munich, Munich, Germany.
authors.forename: Sibylle
authors.initials: S
authors.lastname: Koletzko
authors.affiliation: Department of Pediatrics, Technical University of Munich, Munich, Germany.
authors.forename: Carl-Peter
authors.initials: CP
authors.lastname: Bauer
authors.affiliation: IUF-Leibniz Research Institute for Environmental Medicine, Germany and Medical Faculty, University of Düsseldorf, Düsseldorf, Germany.
authors.forename: Barbara
authors.initials: B
authors.lastname: Hoffmann
authors.affiliation: Institute of Epidemiology I, Helmholtz Zentrum München-German Research Center for Environment Health, Neuherberg, Germany.
authors.forename: Joachim
authors.initials: J
authors.lastname: Heinrich
authors.affiliation: Institute of Epidemiology I, Helmholtz Zentrum München-German Research Center for Environment Health, Neuherberg, Germany.
authors.forename: Holger
authors.initials: H
authors.lastname: Schulz
mesh_terms: D000293:Adolescent; D001249:Asthma / Q000453:epidemiology; D002585:Cesarean Section; D015331:Cohort Studies; D036861:Delivery, Obstetric; D005260:Female; D005500:Follow-Up Studies; D005858:Germany / Q000453:epidemiology; D006801:Humans; D016014:Linear Models; D008297:Male; D011247:Pregnancy; D012129:Respiratory Function Tests; D011795:Surveys and Questionnaires
keywords: C-Section; asthma; lung function