title: Mode of Delivery and Risk of Celiac Disease: Risk of Celiac Disease and Age at Gluten Introduction Cohort Study.
abstract: To determine whether the mode of delivery is associated with the risk of celiac disease (CD) in a cohort of children genetically predisposed to CD prospectively followed from birth.
  
  
  
  By telephone interview, we recorded information on the mode of delivery of children participating in the Risk of Celiac Disease and Age at Gluten Introduction study, a multicenter, prospective intervention trial that compared early and delayed introduction of gluten in infants with at least 1 first-degree relative affected with CD. The human leukocyte antigen genotype was determined at 15 months of age, and serologic screening for CD was performed at 15, 24, and 36 months of age and at 5, 8, and 10 years of age. Patients with positive serologic findings underwent intestinal biopsy. The primary outcome of the current study was the prevalence of CD autoimmunity and overt CD at 5 years of age, according to the mode of delivery.
  
  
  
  The study-group included 553 children at CD risk because of positivity for human leukocyte antigen-DQ2, -DQ8, or both. We obtained data on the mode of delivery from 431 of 553 children; 233 of 431 children were born by vaginal delivery (54%). At 5 years of age, the prevalence of CD autoimmunity or overt CD was not different between children born by cesarean or vaginal delivery (24% and 19%, P = .2; 19% and 14%, P = .2 respectively, by the log-rank test).
  
  
  
  In this cohort of children genetically predisposed to CD, the mode of delivery did not influence the risk of developing CD.
authors.affiliation: Departments of Pediatrics, Marche Polytechnic University, Ancona, Italy.
authors.forename: Elena
authors.initials: E
authors.lastname: Lionetti
authors.affiliation: Department of Pediatrics, San Paolo Hospital, Bari, Italy.
authors.forename: Stefania
authors.initials: S
authors.lastname: Castellaneta
authors.affiliation: Department of Developmental Biomedicine, University of Bari, Bari, Italy.
authors.forename: Ruggiero
authors.initials: R
authors.lastname: Francavilla
authors.affiliation: Department of Clinical and Molecular Biomedicine, University of Catania, Catania, Italy.
authors.forename: Alfredo
authors.initials: A
authors.lastname: Pulvirenti
authors.affiliation: Departments of Pediatrics, Marche Polytechnic University, Ancona, Italy; Center for Celiac Research, MassGeneral Hospital for Children and the Celiac Program, Harvard Medical School, Boston, MA. Electronic address: c.catassi@univpm.it.
authors.forename: Carlo
authors.initials: C
authors.lastname: Catassi
mesh_terms: D000367:Age Factors; D002446:Celiac Disease / Q000453:epidemiology* / Q000235:genetics; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D036861:Delivery, Obstetric / Q000379:methods*; D004032:Diet; D005260:Female; D020022:Genetic Predisposition to Disease; D005983:Glutens; D006801:Humans; D008297:Male; D015995:Prevalence; D011446:Prospective Studies; D018570:Risk Assessment
chemical_list: D005983:Glutens
keywords: cesarean delivery; infants; vaginal delivery