Yeah, people don’t talk about this topic much. Whether to C-section or not is such a polarising topic (along with breast-feeding, introducing solids, smacking, and whether it’s OK as a parent to drug yourself with Valium on a long-haul flight so that you sleep for the whole flight while your five kids run riot.) OK, that last one is not so contentious… But it is a true story.
Let me preface this post by saying I’m not talking here about refusing a C-section when you should really be having one, like when there could be a chance of serious damage or death to mother or baby in the event of a natural delivery (although some would argue that you can deliver a grade IV placenta previa and severe IUGR baby in a febrile woman with ruptured membranes for five days… If you have the ‘skills’…) (I would disagree.) The polarising bit usually comes with women requesting ‘routine’ C-sections.
OK, back to C-sections and immunity. Immune disorders occur when the body is unable to distinguish foreign cells from its own. Think the soldier who goes nuts and kills his own military colleagues… Sadly, not a rare occurrence. One example of an immune disorder is type I diabetes, where the body’s immune system attacks its own insulin-producing cells. Other examples of immune disorders include asthma, allergies, inflammatory bowel disease (just to name a few).
Rates of immune disorders are on the rise in westernised countries. C-section rates are also on the rise. Therefore some have postulated that C-sections could be CAUSING these immune disorders.
A Danish study followed over two million kids in Denmark, and found that children delivered by C-section were at significantly higher risk for asthma, systemic connective tissue disorders, juvenile arthritis, inflammatory bowel disease, immune deficiencies, and leukaemia. That sucks. (No associations were found for type I diabetes, psoriasis, or coeliac disease.)
What’s the reasoning behind C-sections causing immune disorders?
It is thought that your baby’s exposure to pathogens (bugs) in Mum’s V-word (yes, vagina, I know the word freaks some of you out… VA-GINE-AAAH!!! I’m putting it out there. Well, not literally…) colonise the baby’s gut pronto, enabling development of a healthy immune system. As humans we have of course backed this up with extensive animal experimentation (sorry my furry friends) – mice of C-section mothers had poorer immune systems than mice born by natural delivery.
Of course some would say that this is all speculation… at most an association… with further discussions happening re: cause-and effect.
There are other factors to consider:
- Mothers undergoing C-sections are more likely themselves to have immune conditions (asthma, obesity, etc), therefore their kids may be having poorer immunity due to a hereditary/ genetic component, rather than the mode of delivery;
- Also, apart from mode of delivery, there are MANY other factors influencing gut flora – diet, mother’s age and BMI, smoking status, household environment, socioeconomic status, breastfeeding and antibiotic use, as well as other environmental factors that have profound effects on the microbiota and on immunoregulation during early life;
- Many kids with immune disorders are born by natural delivery.
Ah, so much to consider.
In any case, these studies are adding to the increasing pool of data for topics of discussion such as “hygiene hypothesis”, “early life determinants of disease”, and “neonatal programming”.
Welcome your feedback and thoughts! Or any good papers you want to share 🙂
Sevelsted A, Stokholm J, Bønnelykke K, Bisgaard H. Cesarean section and chronic immune disorders. Pediatrics. 2015 Jan;135(1):e92-8. doi: 10.1542/peds.2014-0596. Epub 2014 Dec 1.
External influence of early childhood establishment of gut microbiota and subsequent health implications.
Munyaka PM, Khafipour E, Ghia JE. Front Pediatr. 2014 Oct 9;2:109. doi: 10.3389/fped.2014.00109. eCollection 2014.