Table 3.
Overview of studies included in this review that have linked birth mode with the development of coeliac disease
| Study | Type of study | Subjects | Main findings |
|---|---|---|---|
| [146] | Case control from Germany | 157 coeliac disease cases, 862 controls | Children with coeliac disease had significantly high likelihood of being born by cesarean delivery compared with control subjects (odds ratio: 1.8 [95% confidence interval 1.13–2.88]; P = 0.014) |
| [147] | Prospective birth cohort study from Norway | 650 children with coeliac disease and 107,828 controls | Coeliac disease was not associated with mode of delivery (cesarean section, model 1: OR, 0.84; 95% confidence interval [CI] 0.65–1.09, and model 2: OR, 0.83; 95% CI 0.63–1.09) |
| [148] | Birth Registry-based study from Sweden | 6596 children of who developed coeliac disease before 15 years of age | Among boys, elective caesarean delivery increased the risk of coeliac disease (OR 1.2; 95% CI 1.0–1.4) |
| [149] | Population-based birth cohort study from Sweden | 11,749 coeliac disease and 53,887 age- and sex-matched controls | Positive association between elective cesarean delivery and later coeliac disease (adjusted odds ratio [OR], 1.15; 95% confidence interval [CI] 1.04–1.26) |
| [194] | Birth Registry-based study from UK | 90 children with coeliac disease and 24,8431 children for whom there was no record of admission for coeliac disease | No significant association between coeliac disease and cesarean birth (odds ratio = 0.29; 95% CI 0.07–1.17) (P = 0.064) |
| [195] | Birth Registry-based study from Denmark | 1944 children with coeliac disease | No significant association between coeliac disease and cesarean birth (PARF 0.99 (0.87–1.14); (P = .89) |
| [196] | Birth Registry-based study from Sweden | 3817 children with coeliac disease 191 with had both coeliac disease and T1DM | The increased risk of having a double diagnosis of type 1 diabetes and coeliac disease was associated with being born by Caesarean sections (odds ratio 1.60 (1.07–2.39) |
| [150] | population-based birth cohort from Italy | 1,227 children with coeliac disease, 220230 controls | No significant association between coeliac disease and planned or un-planned cesarean birth |
| [197] | Multinational birth cohort:The TEDDY study | 979 with CDA and 343 with coeliac disease | C-section is not associated with increased risk coeliac disease (HR = 0.85; 95% CI 0.65, 1.11; P = 0.24) and coeliac disease autoimmunity (CDA) (HR = 0.91; 95% CI 0.78, 1.06; P = 0.20) |
| [198] |
Registry-based study from Denmark and Norway |
Denmark: (n = 1,049,633) Cesarean sections (n = 196,512) coeliac disease (n = 1,395) children Norway: (n = 537,457) Cesarean section (n = 90,128) coeliac disease (n = 1,919) |
Mode of delivery was not associated with an increased risk of diagnosed coeliac disease. Odds ratio1.11 (95% CI 0.96–1.29) in the Danish cohort and 0.96 (95% CI 0.84–1.09) in the Norwegian cohort |