Abstract：
Recent studies suggest that children born via cesarean section (CS) are predisposed to immune-mediated diseases later in life. The association between CS and childhood leukemia was investigated in this meta-analysis of observational studies. Two researchers independently searched PubMed, Web of Science, Embase, and Cochrane Library for literature on the association between CS and childhood leukemia before February 2022. And pooled odds ratios (OR) with 95% confidence intervals (CI) were calculated to determine the link between CS and childhood leukemia. The preliminary search resulted in 1321 articles and 16 articles were finally included after screening. The primary outcome was the risk of leukemia in children born via CS versus those born vaginally. The results revealed that having a CS was associated with an increased risk of childhood leukemia compared to having vaginal section (VS) (OR = 1.07, 95% CI: 1.02-1.13, p = 0.01), especially for acute lymphoblastic leukemia (ALL) (OR = 1.09, 95% CI: 1.03-1.16, p = 0.004). Children delivered via elective CS had a higher risk of ALL (OR = 1.18, 95% CI: 1.07-1.31, p = 0.001), but emergency CS did not. It is worth noting that neither emergency CS nor elective CS were found to be associated with acute myeloid leukemia. Compared to VS, CS increased the risk of leukemia in children, with elective CS significantly increasing ALL risk.
摘要：
最近的研究表明，通过剖宫产（CS）出生的儿童在以后的生活中易患免疫介导的疾病。在这项观察性研究的荟萃分析中，研究了CS与儿童白血病之间的关联。两名研究人员独立搜索了PubMed，WebofScience,Embase,和Cochrane图书馆提供2022年2月之前关于CS与儿童白血病之间关联的文献。并计算了具有95％置信区间（CI）的合并比值比（OR），以确定CS与儿童白血病之间的联系。初步检索得到1321篇文章,筛选后最终纳入16篇文章。主要结果是通过CS出生的儿童与阴道出生的儿童患白血病的风险。结果显示，与阴道切片（VS）相比，CS与儿童白血病的风险增加相关（OR=1.07，95％CI：1.02-1.13，p=0.01），尤其是急性淋巴细胞白血病（ALL）（OR=1.09，95％CI：1.03-1.16，p=0.004）。通过选择性CS分娩的儿童发生ALL的风险较高（OR=1.18，95％CI：1.07-1.31，p=0.001），但紧急CS没有。值得注意的是，无论是急诊CS还是选择性CS均未发现与急性髓系白血病相关。与VS相比，CS增加了儿童白血病的风险，选择性CS显着增加所有风险。
