Planned C-sections linked to increased risk of childhood leukemia, study finds
Children born by a planned cesarean is 21% more likely to develop acute lymphoblastic leukemia (all), child cancer, than those born vaginal, according to a new study.
Research, conducted in Sweden, is consistent with previous studies which have also found a link between pediatric risk all risks and cesarean women. More recent research, including this last study, specifically linked the majority of this risk to planned cesareans. In this study, the planned cesareans were defined as those initiated before work.
But above all, the risk of all, and child cancer in general, remains low at all levels, said Joseph WiemelsProfessor of population and public health sciences at the University of Southern California which was not involved in work. In the United States, About 4.8 in 100,000 children receive a diagnosis of leukemia per year. So, while “the relative risk [for ALL] is significantly higher “for babies born by a planned cesarean section, Wiemels has warned that the risk is” still relatively low “overall.
The Cesarean section “is a vital and often vital component of modern obstetric care”, main study author Christina Evmorfia-KampitsiA postdoctoral researcher at Karolina Institutet, told Live Science in an email. Some people give birth by a cesarean planned due to maternal conditions, such as preeclampsiaOr to protect baby’s health because they don’t get enough oxygen, for example.
“Our results should not be a problem with concern when the procedure is indicated medically,” said Evmorfia-Kampitsi.
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Confirm a known link
Which is unique in the study, published on July 4 in the International Cancer Journalis that researchers have checked a range of characteristics in mothers and newborns and have always found a higher risk of all in children born by planned cesarean.
“Thanks to the richness of data from the Swedish register, we were able to adjust for a wide range of kindergartens, pregnancyand neonatal [newborn] Factors, “said Evmorfia-Kampitsi.” [C-section] First. “”
It is important to control these other factors, said Wiemels, in part because the maternal ages greater than 35 years associated with a higher risk Children who develop everything. There is also a link between congenital malformations and all risksas well as environmental factors such as radiation. But because everything occurs at these young ages, researchers have already explored factors and just after birth that can lead to its development, Dr Danielle DaeeProgram director of the Directorate of Genomic Epidemiology at the National Cancer Institute which was not involved in the work, told Live Science in an email.
For the study, the researchers examined the method of childbirth – vaginal, planned or unforeseen cesarean – in more than 2.4 million births which took place in Sweden for 20 years. The data on the weights of newborns, congenital malformations and if their mothers were overweight or had obesity, diabetes or preeclampsia were also examined. In addition, they have examined the impact of all among these children over time.
The researchers also gathered children according to the decade during which they were born, to take into account changes in obstetric practice, the rate of cesarean women, changes in the way childhood cancers are diagnosed and other factors that could vary over time, said Evmorfia-Kampitsi.
More than 375,000 children, around 15%, were born by Cesarean, including around 213,000 planned, who were initiated before the start of work. About 1,200 of the 2.4 million children, or 0.05%, developed everything.
The risk of all was higher in babies born by any type of cesarean than in vaginal born. There was a slight increase in the risk linked to unplanned cesareans, which started after work, but the risk was highest among the born by a planned cesarean, initiated before the start of work.
The planned cesareans could be divided into “planned” and “acute”, the latter, which means that there was a kind of immediate medical need, such as fetal distress. These acute cases did not seem to be linked to any Increased risk of cancer – but because there was only one handful of these cases, it is difficult to draw firm conclusions.
“These results must be interpreted with caution,” said Evmorfia-Kampitsi. “Our main conclusion remains the increased risk associated with the pre-development CS planned.”
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Cause of concern?
Childhood is most often diagnosed in children under the age of 5, and the results of the study were only statistically significant for the children of this age group. In other words, the link between the planned cesareans and everything seems most clear in this age group, said Evmorfia-Kampitsi.
The study can “tell us something about the risk of leukemia and the mechanisms behind this risk,” Wiemels suggested.
On this front, it is known that there are genetic mutations which can develop before birth and cause the birth of children with pre-leukemic cells. However, more children are born with these cells than to develop full cancer, said Erin MarcotteAssociate professor of the pediatric epidemiology and clinical research division at the University of Minnesota, which was not involved in the new study.
“It is likely that most children are able to shoot down these cells,” said Marcotte to Live Science in an email. But how?
There are two main theories on how it works and how these mechanisms can be compromised by planned cesareans. The first suggests that babies born by Cesareanus are missing exposure to microbes in the vaginal channel, which can promote a more “permissive” environment for leukemia to develop, Wiels said. Babies born by cesareans who start before work are exposed to fewer microbes than those whose cesarean begins after work because, at this stage, the water has broken.
The second hypothesis is that babies born by the planned cesarean lack the short -term exposure to the stress hormones that they would generally meet during work. These hormones can be thought of eliminating pre-leukemic cells.
Adding to the idea is the fact that Corticosteroids are a pillar Infantile leukemia treatments and are similar to cortisol made by the body. In addition, Kjeld SchmieGelowClinic teacher at the University of Copenhagen, a hypothesis The fact that the stress that stems from early childhood infections can help eliminate pre-leukemic cells.
Whatever the deep cause of the link, the absolute risk of all remains weak even in the context of the Caesareans. But it is potentially something that doctors must consider, said Evmorfia-Kampitsi. “When a CS is taken into account without a clear medical indication, it is important to be aware of the long-term potential results,” she said.
However, more research on the relationship between all and the planned cesarean section is necessary, because countries with higher cesarean levels do not always have any higher rates of all. Since the study was carried out in Sweden, “it is plausible, but not confirmed, that other populations, with different demographic characteristics and environmental exhibitions, can have a similar result,” said Daee.
This article is for information only and is not supposed to offer medical advice.
