Short-term and long-term effects of caesarean section on the health of women and children

Sandall, J; Tribe, RM; Avery, L; Mola, G; Visser, GH; Homer, CS; Gibbons, D; Kelly, NM; Kennedy, HP; Kidanto, H; Taylor, P; Temmerman, M

Short-term and long-term effects of caesarean section on the health of women and children

Sandall, J

Tribe, RM Avery, L Mola, G Visser, GH Homer, CS

Gibbons, D Kelly, NM Kennedy, HP Kidanto, H Taylor, P Temmerman, M

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Publication Type:: Journal Article
Citation:: The Lancet, 2018, 392 (10155), pp. 1349 - 1357
Issue Date:: 2018-10-13

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Field	Value	Language
dc.contributor.author	Sandall, J https://orcid.org/0000-0003-2000-743X	en_US
dc.contributor.author	Tribe, RM	en_US
dc.contributor.author	Avery, L	en_US
dc.contributor.author	Mola, G	en_US
dc.contributor.author	Visser, GH	en_US
dc.contributor.author	Homer, CS https://orcid.org/0000-0002-7454-3011	en_US
dc.contributor.author	Gibbons, D	en_US
dc.contributor.author	Kelly, NM	en_US
dc.contributor.author	Kennedy, HP	en_US
dc.contributor.author	Kidanto, H	en_US
dc.contributor.author	Taylor, P	en_US
dc.contributor.author	Temmerman, M	en_US
dc.date.available	2018-08-10	en_US
dc.date.issued	2018-10-13	en_US
dc.identifier.citation	The Lancet, 2018, 392 (10155), pp. 1349 - 1357	en_US
dc.identifier.issn	0140-6736	en_US
dc.identifier.uri	http://hdl.handle.net/10453/131438
dc.description.abstract	© 2018 Elsevier Ltd A caesarean section (CS) can be a life-saving intervention when medically indicated, but this procedure can also lead to short-term and long-term health effects for women and children. Given the increasing use of CS, particularly without medical indication, an increased understanding of its health effects on women and children has become crucial, which we discuss in this Series paper. The prevalence of maternal mortality and maternal morbidity is higher after CS than after vaginal birth. CS is associated with an increased risk of uterine rupture, abnormal placentation, ectopic pregnancy, stillbirth, and preterm birth, and these risks increase in a dose–response manner. There is emerging evidence that babies born by CS have different hormonal, physical, bacterial, and medical exposures, and that these exposures can subtly alter neonatal physiology. Short-term risks of CS include altered immune development, an increased likelihood of allergy, atopy, and asthma, and reduced intestinal gut microbiome diversity. The persistence of these risks into later life is less well investigated, although an association between CS use and greater incidence of late childhood obesity and asthma are frequently reported. There are few studies that focus on the effects of CS on cognitive and educational outcomes. Understanding potential mechanisms that link CS with childhood outcomes, such as the role of the developing neonatal microbiome, has potential to inform novel strategies and research for optimising CS use and promote optimal physiological processes and development.	en_US
dc.relation.ispartof	The Lancet	en_US
dc.relation.isbasedon	10.1016/S0140-6736(18)31930-5	en_US
dc.subject.classification	General & Internal Medicine	en_US
dc.subject.mesh	Humans	en_US
dc.subject.mesh	Pregnancy Outcome	en_US
dc.subject.mesh	Cesarean Section	en_US
dc.subject.mesh	Risk Factors	en_US
dc.subject.mesh	Pregnancy	en_US
dc.subject.mesh	Poverty	en_US
dc.subject.mesh	Infant, Newborn	en_US
dc.subject.mesh	Female	en_US
dc.subject.mesh	Global Health	en_US
dc.title	Short-term and long-term effects of caesarean section on the health of women and children	en_US
dc.type	Journal Article
utslib.citation.volume	10155	en_US
utslib.citation.volume	392	en_US
utslib.for	1114 Paediatrics and Reproductive Medicine	en_US
utslib.for	11 Medical and Health Sciences	en_US
pubs.embargo.period	Not known	en_US
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
pubs.organisational-group	/University of Technology Sydney/Faculty of Health/Midwifery
pubs.organisational-group	/University of Technology Sydney/Strength - CHSP - Health Services and Practice
pubs.organisational-group	/University of Technology Sydney/Strength - WHO CC
utslib.copyright.status	closed_access
pubs.issue	10155	en_US
pubs.publication-status	Published	en_US
pubs.volume	392	en_US

Abstract:

© 2018 Elsevier Ltd A caesarean section (CS) can be a life-saving intervention when medically indicated, but this procedure can also lead to short-term and long-term health effects for women and children. Given the increasing use of CS, particularly without medical indication, an increased understanding of its health effects on women and children has become crucial, which we discuss in this Series paper. The prevalence of maternal mortality and maternal morbidity is higher after CS than after vaginal birth. CS is associated with an increased risk of uterine rupture, abnormal placentation, ectopic pregnancy, stillbirth, and preterm birth, and these risks increase in a dose–response manner. There is emerging evidence that babies born by CS have different hormonal, physical, bacterial, and medical exposures, and that these exposures can subtly alter neonatal physiology. Short-term risks of CS include altered immune development, an increased likelihood of allergy, atopy, and asthma, and reduced intestinal gut microbiome diversity. The persistence of these risks into later life is less well investigated, although an association between CS use and greater incidence of late childhood obesity and asthma are frequently reported. There are few studies that focus on the effects of CS on cognitive and educational outcomes. Understanding potential mechanisms that link CS with childhood outcomes, such as the role of the developing neonatal microbiome, has potential to inform novel strategies and research for optimising CS use and promote optimal physiological processes and development.

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http://hdl.handle.net/10453/131438