MedicalResearch.com Interview with:
Erin Marcotte, Ph.D.
Division of Epidemiology and Clinical Research
Department of Pediatrics
University of Minnesota
MedicalResearch.com: What is the background for this study? What are the main findings?
Dr. Marcotte: Recently there have been several studies that indicate a higher risk of immune-related disorders, such as type-I diabetes, asthma, and allergies, among children born by cesarean delivery. Our analysis used pooled data from 13 independent studies of childhood leukemia that were conducted in 9 different countries. We used data on over 33,000 children to investigate the relationship between birth by cesarean delivery and risk of childhood leukemia. We did not find an association between cesarean delivery overall and childhood leukemia. However, when we looked at emergency cesarean deliveries and pre-labor (planned) cesarean deliveries separately, we found a 23% increase in risk of acute lymphoblastic leukemia among children born by pre-labor cesarean delivery.
MedicalResearch.com: What should clinicians and patients take away from your report?
Dr. Marcotte: Our study indicates that cesarean delivery may increase risk for childhood leukemia. However, we don’t know what is driving this association and more research is needed to determine if cesarean delivery is a cause of childhood leukemia. It’s important for patients to know that we’re just beginning to understand the long-term effects of cesarean delivery and that this is an area of ongoing research. The best and safest delivery method for each individual woman will vary based on her health and the health of her baby. Clinicians should be aware of existing research to help their patients make an informed decision.
MedicalResearch.com: What recommendations do you have for future research as a result of this study?
Dr. Marcotte: Additional studies with high-quality data on mode of delivery and length of labor are needed to confirm this association. If these studies produce similar results, we will need to determine what is causing the association. It is known that children born by pre-labor cesarean delivery are exposed to significantly lower levels of stress hormones at birth. These hormones may have beneficial effects on babies’ immune systems. Compounds similar to cortisol, the main stress hormone, are used to treat leukemia and there is some evidence that early exposure to high levels of cortisol may be beneficial. Additionally, the gut microbiome is colonized by the first bacteria an infant comes in contact with, and this differs by mode of birth. The next steps would be to determine the impact of the different exposures and whether they might explain the association.
MedicalResearch.com: Is there anything else you would like to add?
Dr. Marcotte: It’s important for concerned parents to keep in mind that childhood leukemia is very rare and this risk for any child, regardless of mode of birth, is low.
MedicalResearch.com: Thank you for your contribution to the MedicalResearch.com community.
Caesarean delivery and risk of childhood leukaemia: a pooled analysis from the Childhood Leukemia International Consortium (CLIC)
Marcotte, Erin L et al.
The Lancet Haematology , Volume 0 , Issue 0 ,
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Erin Marcotte, Ph.D. (2016). Cesarean Section May Increase Risk of Childhood Leukemia MedicalResearch.com