Observational studyJournal of pediatric gastroenterology and nutrition2018
Cesarean Section on the Risk of Celiac Disease in the Offspring: The Teddy Study.
Observational study in Journal of pediatric gastroenterology and nutrition, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 33 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
33 citing papers in PubMed, 1 synthesis or guideline pooled it, 57 citations in OpenAlex.
- Pooled it
- Trial
- Gastrointestinal consequences of cesarean section birth: A systematic review of short- and long-term effects in infancy and beyond.World journal of clinical pediatrics · 2026Article
- Gene-Environment Interactions in Celiac Disease: The Role of the Intestinal Epithelium.Lifestyle genomics · 2026Review
- Challenges in the Pediatric Celiac Disease Diagnosis: An Up-to-Date Review.Diagnostics (Basel, Switzerland) · 2025Review
- Unfolding the Mystery of Autoimmunity: The Environmental Determinants of Diabetes in the Young (TEDDY) Study.Diabetes care · 2025Review
- Looking back at the TEDDY study: lessons and future directions.Nature reviews. Endocrinology · 2025Review
- Environmental Factors Associated With Celiac Disease in Children in Southeast Iran: A Case-Control Study.International journal of pediatrics · 2025Article
- The importance of gut microbiome in the perinatal period.European journal of pediatrics · 2024Review
- Prevalence of delivery mode in an Italian nationwide cohort with celiac disease: a SIGENP multicenter retrospective study (the CD-deliver-IT).Italian journal of pediatrics · 2024Article
- Investigating the role of iron status in the development of coeliac disease: a Mendelian randomisation study.BMJ open gastroenterology · 2024Article
- Celiac disease - a pluripathological model in pediatric practice.Frontiers in immunology · 2024Review
- From an understanding of etiopathogenesis to novel therapies-what is new in the treatment of celiac disease?Frontiers in pharmacology · 2024Review
- Coeliac disease: what can we learn from prospective studies about disease risk?The Lancet. Child & adolescent health · 2024Review
- Celiac Disease Genetics, Pathogenesis, and Standard Therapy for Japanese Patients.International journal of molecular sciences · 2023Review
- Infant gut microbiota colonization: influence of prenatal and postnatal factors, focusing on diet.Frontiers in microbiology · 2023Review
- Crucial nuances in understanding (mis)associations between the neonatal microbiome and Cesarean delivery.Trends in molecular medicine · 2022Review
- Celiac Disease and Targeting the Molecular Mechanisms of Autoimmunity in COVID Pandemic.International journal of molecular sciences · 2022Review
- The global burden of coeliac disease: opportunities and challenges.Nature reviews. Gastroenterology & hepatology · 2022Review
- Why are western diet and western lifestyle pro-inflammatory risk factors of celiac disease?Frontiers in nutrition · 2022Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
18 authors at 13 institutions in 4 countries.
Funding
Abstract
objectiveCesarean section (C-section) is associated with various immune-mediated diseases in the offspring. We investigated the relationship between mode of delivery and celiac disease (CD) and CD autoimmunity (CDA) in a multinational birth cohort.
methodsFrom 2004 to 2010, infants from the general population who tested positive for HLA DR3-DQ2 or DR4-DQ8 were enrolled in The Environmental Determinants for Diabetes in the Young (TEDDY) study. Children were annually screened for transglutaminase autoantibodies, if positive, they are retested after 3 to 6 months and those persistently positive defined as CDA. Associations of C-section with maternal (age, education level, parity, pre-pregnancy weight, diabetes, smoking, weight gain during pregnancy) and child characteristics (gestational age, birth weight) were examined by Fisher exact test or Wilcoxon rank-sum test. Hazard ratios (HRs) for CDA or CD were calculated by Cox proportional hazard regression models.
resultsOf 6087 analyzed singletons, 1600 (26%) were born by C-section (Germany 38%, United States 37%, Finland 18%, Sweden 16%), and the remaining were born vaginally without instrumental support; 979 (16%) had developed CDA and 343 (6%) developed CD. C-section was associated with lower risk for CDA (hazard ratio [HR] = 0.85; 95% confidence interval [CI] 0.73, 0.99 P = 0.032) and CD (HR = 0.75; 95% CI 0.58, 0.98; P = 0.034). After adjusting for country, sex, HLA-genotype, CD in family, maternal education, and breast-feeding duration, significance was lost for CDA (HR = 0.91; 95% CI 0.78, 1.06; P = 0.20) and CD (HR = 0.85; 95% CI 0.65, 1.11; P = 0.24). Presurgical ruptured membranes had no influence on CDA or CD development.
conclusionC-section is not associated with increased risk for CDA or CD in the offspring.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.