6.5 Long-term childhood outcomes following caesarean section: Systematic Review and Meta-Analysis.

: Rates of caesarean section (CS) continue to rise in the UK. CS on maternal request is now endorsed by NICE, with NICE emphasising the importance of informed decision-making. The short-term consequences of CS for mother and baby are summarized in the NICE guideline on caesarean section. However, the long-term consequences of CS are less frequently discussed with women. We searched Medline, Embase, Cochrane and Google Scholar databases for randomised controlled trials and prospective cohort studies comparing childhood outcomes following primary CS and vaginal delivery. Additional studies were identified from reference lists of relevant papers. We restricted inclusion to studies of 1000 or more participants and with follow-up of greater than one year. The quality of studies was assessed using SIGN criteria. RevMan was used to compile data and construct a meta-analysis. We identified 13 papers which included around 250 000 babies delivered by CS. Odds ratios for specific childhood outcomes are displayed in the table below. fetalneonatal;99/Suppl_1/A8-c/T1T1T1 Abstract 6.5 Table Outcome Follow-up Odds ratio 95% CI Asthma 12 years 1.33 1.25-1.41 Wheeze 5 years 1.07 1.02-1.13 Wheeze 6-15 years 1.07 0.96-1.19 Obesity 5 years 1.65 1.45-1.88 Obesity 6-15 years 1.28 1.17--1.40 Summary Babies delivered by CS have an increased risk of asthma, wheeze and obesity during childhood. This information should be valuable in helping pregnant women make informed choices about mode of delivery.