Association between cesarean birth and childhood cancer: An age-lagged approach

AIM: We assessed the association between cesarean birth and age-specific risks of childhood cancer. METHODS: We followed a cohort of 1,034,049 children between 2006 and 2020 in Quebec, Canada, from birth until age 14 years. The exposure was cesarean, operative vaginal, or spontaneous vaginal birth. The outcome included hematopoietic or solid tumors. We calculated hazard ratios (HR) and 95% confidence intervals (CI) for the association between mode of delivery and childhood cancer in age-lagged analyses, adjusted for potential confounders. RESULTS: A total of 249,415 (24.1%) children were born by cesarean and 97,411 (9.4%) by operative vaginal delivery. Compared with spontaneous vaginal birth, cesarean was associated with 1.16 times the risk of any cancer (95% CI 1.04-1.30), 1.12 times the risk of hematopoietic cancer (95% CI 0.92-1.36), and 1.21 times the risk of solid tumors (95% 1.06-1.39). Associations strengthened at 2 years of age and were greatest for lymphoma and sarcoma. Operative vaginal birth was not significantly associated with the risk of cancer. CONCLUSION: Cesarean birth may be associated with selected childhood cancers, including lymphoma and sarcoma early in childhood. The underlying reasons for the associations require further investigation, including whether mucosal dysbiosis or labor hormone exposure explain the excess risk.
Auteurs (Zotero)
Marcoux, Sophie; Soullane, Safiya; Lee, Ga Eun; Auger, Nathalie
Date de publication (Zotero)
mars, 2022