Caesarean Section on The Risk of Celiac Disease in the Offspring: The Teddy Study

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Caesarean Section on The Risk of Celiac Disease in the Offspring : The Teddy Study. / Koletzko, Sibylle; Lee, Hye-Seung; Beyerlein, Andreas; Aronsson, Carin A.; Hummel, Michael; Liu, Edwin; Simell, Ville; Kurppa, Kalle; Lernmark, Åke; Hagopian, William; Rewers, Marian; She, Jin-Xiong; Simell, Olli; Toppari, Jorma; Ziegler, Anette G.; Krischer, Jeffrey; Agardh, Daniel; TEDDY Study Group.

In: Journal of Pediatric Gastroenterology and Nutrition, Vol. 66, No. 3, 2018, p. 417-424.

Research output: Contribution to journalArticle

Harvard

Koletzko, S, Lee, H-S, Beyerlein, A, Aronsson, CA, Hummel, M, Liu, E, Simell, V, Kurppa, K, Lernmark, Å, Hagopian, W, Rewers, M, She, J-X, Simell, O, Toppari, J, Ziegler, AG, Krischer, J, Agardh, D & TEDDY Study Group 2018, 'Caesarean Section on The Risk of Celiac Disease in the Offspring: The Teddy Study', Journal of Pediatric Gastroenterology and Nutrition, vol. 66, no. 3, pp. 417-424. https://doi.org/10.1097/MPG.0000000000001682

APA

Koletzko, S., Lee, H-S., Beyerlein, A., Aronsson, C. A., Hummel, M., Liu, E., Simell, V., Kurppa, K., Lernmark, Å., Hagopian, W., Rewers, M., She, J-X., Simell, O., Toppari, J., Ziegler, A. G., Krischer, J., Agardh, D., & TEDDY Study Group (2018). Caesarean Section on The Risk of Celiac Disease in the Offspring: The Teddy Study. Journal of Pediatric Gastroenterology and Nutrition, 66(3), 417-424. https://doi.org/10.1097/MPG.0000000000001682

CBE

Koletzko S, Lee H-S, Beyerlein A, Aronsson CA, Hummel M, Liu E, Simell V, Kurppa K, Lernmark Å, Hagopian W, Rewers M, She J-X, Simell O, Toppari J, Ziegler AG, Krischer J, Agardh D, TEDDY Study Group. 2018. Caesarean Section on The Risk of Celiac Disease in the Offspring: The Teddy Study. Journal of Pediatric Gastroenterology and Nutrition. 66(3):417-424. https://doi.org/10.1097/MPG.0000000000001682

MLA

Vancouver

Author

Koletzko, Sibylle ; Lee, Hye-Seung ; Beyerlein, Andreas ; Aronsson, Carin A. ; Hummel, Michael ; Liu, Edwin ; Simell, Ville ; Kurppa, Kalle ; Lernmark, Åke ; Hagopian, William ; Rewers, Marian ; She, Jin-Xiong ; Simell, Olli ; Toppari, Jorma ; Ziegler, Anette G. ; Krischer, Jeffrey ; Agardh, Daniel ; TEDDY Study Group. / Caesarean Section on The Risk of Celiac Disease in the Offspring : The Teddy Study. In: Journal of Pediatric Gastroenterology and Nutrition. 2018 ; Vol. 66, No. 3. pp. 417-424.

RIS

TY - JOUR

T1 - Caesarean Section on The Risk of Celiac Disease in the Offspring

T2 - The Teddy Study

AU - Koletzko, Sibylle

AU - Lee, Hye-Seung

AU - Beyerlein, Andreas

AU - Aronsson, Carin A.

AU - Hummel, Michael

AU - Liu, Edwin

AU - Simell, Ville

AU - Kurppa, Kalle

AU - Lernmark, Åke

AU - Hagopian, William

AU - Rewers, Marian

AU - She, Jin-Xiong

AU - Simell, Olli

AU - Toppari, Jorma

AU - Ziegler, Anette G.

AU - Krischer, Jeffrey

AU - Agardh, Daniel

AU - TEDDY Study Group

PY - 2018

Y1 - 2018

N2 - OBJECTIVE:: Caesarean 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. METHODS:: From 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 re-tested after 3–6 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 Fisherʼs exact test or Wilcoxon rank-sum test. Hazard ratios (HRs) for CDA or CD were calculated by Cox proportional hazard regression models. RESULTS:: Of 6,087 analyzed singletons 1600 (26%) were born by C-section (Germany 38%, US 37%, Finland 18%, Sweden 16%), the remaining vaginally without instrumental support; 979 (16%) had developed CDA and 343 (6%) CD. C-section was associated with lower risk for CDA (HR?=?0.85, [95% 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 breastfeeding 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). Pre-surgical ruptured membranes had no influence on CDA or CD development. CONCLUSION:: C-section is not associated with increased risk for CDA or CD in the offspring.

AB - OBJECTIVE:: Caesarean 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. METHODS:: From 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 re-tested after 3–6 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 Fisherʼs exact test or Wilcoxon rank-sum test. Hazard ratios (HRs) for CDA or CD were calculated by Cox proportional hazard regression models. RESULTS:: Of 6,087 analyzed singletons 1600 (26%) were born by C-section (Germany 38%, US 37%, Finland 18%, Sweden 16%), the remaining vaginally without instrumental support; 979 (16%) had developed CDA and 343 (6%) CD. C-section was associated with lower risk for CDA (HR?=?0.85, [95% 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 breastfeeding 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). Pre-surgical ruptured membranes had no influence on CDA or CD development. CONCLUSION:: C-section is not associated with increased risk for CDA or CD in the offspring.

UR - http://www.scopus.com/inward/record.url?scp=85026445219&partnerID=8YFLogxK

U2 - 10.1097/MPG.0000000000001682

DO - 10.1097/MPG.0000000000001682

M3 - Article

C2 - 28753178

AN - SCOPUS:85026445219

VL - 66

SP - 417

EP - 424

JO - Journal of Pediatric Gastroenterology and Nutrition - Jpgn

JF - Journal of Pediatric Gastroenterology and Nutrition - Jpgn

SN - 1536-4801

IS - 3

ER -