A recent study (E Lionetti et al. J Pediatr 2017; 184: 81-6) did NOT find an association between mode of delivery and the development of celiac disease (CD).
After a telephone interview to confirm mode of delivery, the authors identified 431 children at high risk for CD and compared the rates of celiac autoimmunity (serology-positive) and overt CD that developed by age 5 years:
- CD autoimmunity –cesarean vs vaginal: 24% and 19% (P=.2)
- Overt CD –cesarean vs vaginal: 19% and 14% (P=.2)
While neither reached statistical significance, there was a higher rate in those born by cesarean mode. The lack of a statistical association could be a reflection on sample size or the specific population that was studied. However, more likely, this suggests that “the role of intestinal microbiota at birth in the pathogenesis of immune mediated disorders has been overestimated.”
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