Credit: wikipedia

TUESDAY August 26, 2008 (foodconsumer.org) -- Caesarean section may increase type 1 diabetes in the childhood of babies who were delivered by the procedure, according to a study led by researchers at Queen's University Belfast.

The study showed babies delivered by Caesarean section were 20 percent more likely to develop type 1 diabetes in childhood than those who were delivered naturally.

The finding was based on a review of 20 published studies from 16 countries involving about 10,000 children with type 1 diabetes and over one million control children.

Dr Chris Cardwell and Dr Chris Patterson, study authors, from the School of Medicine, Dentistry and Biomedical Sciences, said the increased risk could not be explained by diabetes factors such as birth weight, the age of the mother, order of birth, gestational diabetes and whether the baby was breast-fed or not.

Dr Cardwell said: "It is important to stress that the reason for this is still not understood. It is possible that children born by Caesarean section differ from other children with respect to some unknown characteristic which consequently increases their risk of diabetes, but it is also possible that Caesarean section itself is responsible."

Dr. Cardwell explained that one theory is that caesarean section may affect the development of the immune system because of exposure to hospital-borne bacteria rather than to maternal bacteria.

Type 1 diabetes also known as juvenile diabetes is a form of diabetes mellitus. The autoimmune disease results in the permanent destruction of insulin-producing beta cells of the pancreas.

Diabetes is a serious condition that can lead to fatal complications such as heart disease, stroke, kidney failure and amputations.   An estimated 20 million Americans suffer diabetes with most type 2 diabetes.

Caesarean section is not uncommon in the U.S.   Up to 30 percent of babies in the country are delivered by C-section, according to Wikipedia.   The World Health Organization recommends the rate should be controlled below 15 percent.  

Risks associated with this procedure were well documented. Below is some information on C-section risks cited from the online free encyclopedia.

Statistics from the 1990s suggest that less than one woman in 2,500 who has a caesarean section will die, compared to a rate of one in 10,000 for a vaginal delivery.[9] However the mortality rate for both continues to drop steadily. The UK National Health Service gives the risk of death for the mother as three times that of a vaginal birth.[10] However, it is misleading to directly compare the mortality rates of vaginal and caesarean deliveries. Women with severe medical disease often require a caesarean section which can distort the mortality figures.

A study published in the 13 February 2007 issue of the Canadian Medical Association Journal found that women that have planned caesareans had an overall rate of severe morbidity of 27.3 per 1000 deliveries compared to an overall rate of severe morbidity of 9.0 per 1000 planned vaginal deliveries. The planned caesarean group had increased risks of cardiac arrest, wound haematoma, hysterectomy (alt PPH - Post Pregnancy Hysterectomy), major puerperal infection, anaesthetic complications, venous thromboembolism, and haemorrhage requiring hysterectomy over those suffered by the planned vaginal delivery group. [11] Again, these figures can be significantly distorted given that women with severe health conditions are more likely to preschedule births by caesarean.

A study published in the February 2007 issue of the journal Obstetrics and Gynecology found that women who had just one previous caesarean section were more likely to have problems with their second birth. Women who delivered their first child by caesarean delivery had increased risks for malpresentation, placenta previa, antepartum hemorrhage, placenta accreta, prolonged labor, uterine rupture, preterm birth, low birth weight, and stillbirth in their second delivery.[12]

A study published in the June 2006 issue of the journal Obstetrics and Gynecology found that women who had multiple caesarean sections were more likely to have problems with later pregnancies, and recommended that women who want larger families should not seek caesarean section as an elective. The risk of placenta accreta, a potentially life-threatening condition, is only 0.13% after two c-sections but increases to 2.13% after four and then to 6.74% after six or more surgeries. Along with this is a similar rise in the risk of emergency hysterectomies at delivery. The findings were based on outcomes from 30,132 caesarean deliveries.[13] (see also review by WebMD.com)

A caesarean section is a major operation, with all that it entails, including the risk of post-operative adhesions. Pain at the incision can be intense, and full recovery of mobility can take several weeks or more. A prior caesarean section increases the risk of uterine rupture during subsequent labour.

If a caesarean is performed under emergency situations, the risk of the surgery may be increased due to a number of factors. The patient's stomach may not be empty, increasing the anesthesia risk.[14]

9    Robin Elise Weiss. " Risks of Cesarean Section". childbirth.org. Retrieved on 2006- 07-26.

10    " Cesarean Section". NHS Direct. Retrieved on 2006- 07-26.

11   Liu, Shiliange, Maternal mortality and severe morbidity associated with low-risk planned caesarean delivery versus planned vaginal delivery at term Canadian Medical Association Journal, 13 February 2007; 176 (4).

12    Risks of Adverse Outcomes in the Next Birth After a First Cesarean Delivery Kennare, Robyn Obstetrics and Gynecology, February 2007, vol. 109; pp. 270-276.

13    Silver, R.M. Obstetrics and Gynecology, June 2006; vol. 107: pp. 1226-1232.

14    " Why are Caesareans Done?". Gynaecworld. Retrieved on 2006- 07-26.