Evidence map›Paper›PMID 30266042›Full record

SynthesisPaediatric and perinatal epidemiology2018

Caesarean delivery, childhood asthma, and effect modification by sex: An observational study and meta-analysis.

Audrey Flak Pennington, Matthew J Strickland, Mitchel Klein, Carolyn Drews-Botsch, Craig Hansen, Lyndsey A Darrow

Open access · greenAbstract readMeta-AnalysisObservational Study
In one paragraph

Synthesis in Paediatric and perinatal epidemiology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed, 1 pooled it
1.4field-weighted citation impact, top 17% of its field
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 1 synthesis or guideline pooled it, 16 citations in OpenAlex.

  1. Pooled it
  2. Trial
  3. Article
  4. Review
  5. Review
  6. Article
  7. Review
  8. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 3 institutions in 1 country.

Audrey Flak PenningtonDepartment of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, Georgia.ORCID 0000-0002-6233-6269
Matthew J StricklandSchool of Community Health Sciences, University of Nevada Reno, Reno, Nevada.ORCID 0000-0003-3027-5470
Mitchel KleinDepartment of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, Georgia.
Carolyn Drews-BotschDepartment of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia.ORCID 0000-0002-8763-7404
Craig HansenCenter for Clinical and Outcomes Research, Kaiser Permanente Georgia, Atlanta, Georgia.
Lyndsey A DarrowSchool of Community Health Sciences, University of Nevada Reno, Reno, Nevada.ORCID 0000-0002-0137-8975
Emory University · USUniversity of Nevada, Reno · USKaiser Permanente · US

Funding

Prenatal, Intrapartum and Infant Antibiotic Use and Atopic Diseases in ChildhoodR01AI122266 · NIAID · UNIVERSITY OF NEVADA RENO · PI DARROW, LYNDSEY · 2016 to 2020
$3.7M
NIAID NIH HHS R01 AI122266
6 · The paper itself

Abstract

backgroundNumerous studies indicate caesarean delivery is associated with childhood asthma. Sex-specific associations were reported in four of these studies, and in all four studies, the estimated association between caesarean delivery and asthma was of greater magnitude among girls, although most report a lack of evidence of multiplicative interaction.

methodsWe assessed potential effect modification by sex, on the additive and multiplicative scales, of the association between caesarean delivery and asthma by ages 2 through 6 in up to 17 075 racially diverse children from a retrospective birth cohort, the Kaiser Air Pollution and Pediatric Asthma (KAPPA) Study. We also conducted a random-effects meta-analysis, combining our sex-stratified results (using the odds ratio for compatibility with previous studies) with previously published results.

resultsAdjusted risk differences for caesarean delivery and asthma in the KAPPA cohort were higher among girls than boys at every follow-up age. By age 5, caesarean delivery was associated with an absolute 3.8% (95% confidence interval [CI] 0.4%, 7.3%) higher asthma risk among girls and a 1.9% (95% CI -1.7, 5.4) higher risk among boys. The summary odds ratio from the meta-analysis for caesarean delivery and asthma among girls was 1.26 (95% CI 1.14, 1.39) and 1.08 (95% CI 0.98, 1.20) among boys (P = 0.036).

conclusionsHigher, but imprecise, estimates for females across five studies should motivate investigators to estimate sex-specific associations for caesarean delivery and asthma and to explore biological mechanisms or sex-dependent biases that could explain this possible heterogeneity.

Indexed as

AsthmaCesarean SectionSex CharacteristicsChildFemaleHumansInfant, NewbornMaleOdds RatioRetrospective StudiesSex Factorsasthmacaesarean deliveryeffect modificationsex

Identifiers

PMID30266042
PMCPMC6261703
OpenAlexW2893208113

What OpenQuestion holds

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Registered trials

None linked

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.