The prevalence of food allergy in cesarean-born children aged 0-3 years: A systematic review and meta-analysis of cohort studies

Xiaoxian Yang; Chuhui Zhou; Chentao Guo; Jie Wang; Innie Chen; Shi Wu Wen; Daniel Krewski; Liqun Yue; Ri-Hua Xie

doi:10.3389/fped.2022.1044954

The prevalence of food allergy in cesarean-born children aged 0-3 years: A systematic review and meta-analysis of cohort studies

Front Pediatr. 2023 Jan 17:10:1044954. doi: 10.3389/fped.2022.1044954. eCollection 2022.

Authors

Xiaoxian Yang¹, Chuhui Zhou^{2

3}, Chentao Guo⁴, Jie Wang^{2

3}, Innie Chen^{5

6

7}, Shi Wu Wen^{5

6

7}, Daniel Krewski^{6

8

9}, Liqun Yue¹⁰, Ri-Hua Xie^{2

11}

Affiliations

¹ School of Health and Nursing, Wuxi Taihu University, Wuxi, China.
² Affiliated Foshan Maternity & Child Healthcare Hospital, Southern Medical University, Foshan, China.
³ School of Nursing, Southern Medical University, Guangzhou, China.
⁴ Department of Epidemiology, Xishan Center for Disease Control and Prevention, Wuxi, China.
⁵ Department of Obstetrics & Gynecology, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada.
⁶ School of Epidemiology and Public Health, University of Ottawa Faculty of Medicine, Ottawa, ON, Canada.
⁷ Ottawa Hospital Research Institute, Ottawa, ON, Canada.
⁸ McLaughlin Centre for Population Health Risk Assessment, University of Ottawa Faculty of Medicine, Ottawa, ON, Canada.
⁹ Risk Science International, Ottawa, ON, Canada.
¹⁰ Department of Nursing, The Affiliated Hospital of Guangdong Medical University, Zhanjiang, China.
¹¹ The Telfer School of Management, University of Ottawa, Ottawa, ON, Canada.

Abstract

Purpose: Previous studies reported a higher risk of food allergy for cesarean-born children than vaginal-born children. This study aims to systematically compare the prevalence of food allergy among cesarean-born and vaginal-born children aged 0-3 years.

Methods: Three English and two Chinese databases were searched using terms related to food allergies and cesarean sections. Cohort studies that reported the prevalence of food allergy in cesarean-born and vaginal-born children aged 0-3 years were included. Two reviewers performed study selection, quality assessment, and data extraction. The pooled prevalence of food allergy in cesarean-born and vaginal-born children was compared by meta-analysis.

Results: Nine eligible studies, with 9,650 cesarean-born children and 20,418 vaginal-born children aged 0-3 years, were included. Of them, 645 cesarean-born children and 991 vaginal-born children were identified as having food allergies. The pooled prevalence of food allergy was higher in cesarean-born children (7.8%) than in vaginal-born children (5.9%). Cesarean section was associated with an increased risk of food allergy [odds ratio (OR): 1.45; 95% confidence interval (CI): 1.03-2.05] and cow's milk allergy (OR: 3.31; 95% CI: 1.98-5.53). Additionally, cesarean-born children with a parental history of allergy had an increased risk of food allergy (OR: 2.60; 95% CI: 1.28-5.27).

Conclusion: This study suggests that cesarean sections was associated with an increased risk of food and cow's milk allergies in children aged 0-3 years. Cesarean-born children with a parental history of allergy demonstrated a higher risk for food allergy than did vaginal-born children. These results indicate that caregivers should be aware of the risks of food allergies in cesarean-born children, reducing the risk of potentially fatal allergic events. Further research is needed to identify the specific factors affecting food allergies in young children.

Systematic review registration: http://www.crd.york.ac.uk/prospero, identifier: International Prospective Register of Systematic Reviews (NO. CRD42019140748).

Keywords: cesarean-born; children aged 0–3 years; food allergy; meta-analysis; prevalence of food allergy.

Publication types

Review

Grants and funding

This study was funded by Jiangsu Provincial Department of Education (grant no. 20KJB330006), Canadian Institute of Health Research (grant nos. FDN-148438, PJT-178049, and P14-175351), and Clinical Research Startup Program of Southern Medical University by High-level University Construction Funding of Guangdong Provincial Department of Education (grant no. LC2019ZD019).