Relationship between mode of delivery and the development of allergic rhinitis: a systematic review and meta-analysis.

IF 4.8 2区医学 Q1 OTORHINOLARYNGOLOGY

Rhinology Pub Date : 2025-02-01 DOI:10.4193/Rhin24.262

M P Hoang, K Seresirikachorn, J Samuthpongtorn, W Chitsuthipakorn, K Snidvongs

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引用次数: 0

Abstract

Background: Delivery mode can influence infant microbial diversity, cause immune dysregulation, and potentially increase the risk of allergic rhinitis (AR).

Methodology: A systematic review and meta-analysis were performed to assess the association between distinct modes of delivery and the development of AR in childhood and adulthood. The primary comparison was vaginal (VD) versus cesarean delivery (CD). Secondary comparisons were specified CD (elective, emergency) versus specified VD (spontaneous, abnormal) and nonmicrobiota-exposed versus microbiota-exposed deliveries. The outcomes were subsequent risks of AR presenting as odd ratios and 95% confidence intervals.

Results: Thirty-seven studies were analyzed. Compared to VD, CD, and its specified modes were associated with higher subsequent risks of AR in the population under age 18. The quality of evidence supporting these effects is rated as very low to low following GRADE. Spontaneous VD was associated with lower AR risk compared to CD, but there was no significant difference between abnormal VD and CD. The distinction between non-microbiota-exposed and microbiota-exposed deliveries did not affect AR risk significantly.

Conclusions: The estimated odds ratios demonstrated a positive association between cesarean section and AR up to 18 years of age. A comprehensive categorization of delivery mode is necessary to interpret the existing evidence thoroughly.

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分娩方式与变应性鼻炎发生的关系：一项系统回顾和荟萃分析。

背景：分娩方式会影响婴儿微生物多样性，导致免疫失调，并可能增加变应性鼻炎（AR）的风险。方法：进行系统回顾和荟萃分析，以评估不同分娩方式与儿童期和成年期AR发展之间的关系。主要比较的是阴道分娩（VD）和剖宫产分娩（CD）。次要比较是特定的CD（选择性，紧急）与特定的VD（自发，异常）以及非微生物群暴露与微生物群暴露的分娩。结果是AR的后续风险表现为奇数比和95%置信区间。结果：分析了37项研究。与VD相比，CD及其特定模式与18岁以下人群随后发生AR的风险较高相关。支持这些效果的证据的质量被评为非常低到低的GRADE。与CD相比，自发性VD与AR风险较低相关，但异常VD和CD之间没有显著差异。非微生物群暴露和微生物群暴露分娩之间的差异并未显著影响AR风险。结论：估计的优势比显示剖宫产与18岁以下AR呈正相关。为了彻底解释现有证据，有必要对交付方式进行全面的分类。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Rhinology 医学-耳鼻喉科学

CiteScore

15.80

自引率

9.70%

发文量

135

审稿时长

6-12 weeks

期刊介绍： Rhinology serves as the official Journal of the International Rhinologic Society and is recognized as one of the journals of the European Rhinologic Society. It offers a prominent platform for disseminating rhinologic research, reviews, position papers, task force reports, and guidelines to an international scientific audience. The journal also boasts the prestigious European Position Paper in Rhinosinusitis (EPOS), a highly influential publication first released in 2005 and subsequently updated in 2007, 2012, and most recently in 2020. Employing a double-blind peer review system, Rhinology welcomes original articles, review articles, and letters to the editor.