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Delivery by caesarean section and childhood cancer: a nationwide follow‐up study in three countries
Author(s) -
Momen NC,
Olsen J,
Gissler M,
Cnattingius S,
Li J
Publication year - 2014
Publication title -
bjog: an international journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.157
H-Index - 164
eISSN - 1471-0528
pISSN - 1470-0328
DOI - 10.1111/1471-0528.12667
Subject(s) - caesarean section , medicine , hazard ratio , obstetrics , confidence interval , population , cancer , pediatrics , pregnancy , childhood cancer , demography , environmental health , genetics , sociology , biology
Objective To investigate the association between delivery by caesarean section and risk of childhood cancer. Design A population‐based, follow‐up study using register data from three countries. Setting D enmark, S weden and F inland. Population Children born in D enmark (1973–2007), S weden (1973–2006) and F inland (randomly selected sample of 90%, 1987–2007; n = 7 029 843). Methods Exposure was delivery by caesarean section and the outcome was childhood cancer diagnosis. Follow‐up started from birth and ended at the first of the following dates: cancer diagnosis, death, emigration, day before 15th birthday or end of follow‐up. Cox regression was used to obtain hazard ratios. Main outcome measures Childhood cancer diagnosis. Results A total of 882 907 (12.6%) children were delivered by caesarean section. Of these, 30.3% were elective ( n = 267 603), 35.9% unplanned ( n = 316 536) and 33.8% had no information on planning ( n = 298 768). Altogether, 11 181 children received a cancer diagnosis. No evidence of an increased risk of childhood cancer was found for children born by caesarean section (hazard ratio, 1.05; 95% confidence interval, 0.99, 1.11). No association was found for any major type of childhood cancer, or when split by the type of caesarean section (elective/unplanned). Conclusion The evidence does not suggest that caesarean section is a risk factor for the overall risk of childhood cancer and possibly not for subtypes of childhood cancer either.