Caesarean delivery and anaemia risk in children in 45 low‐ and middle‐income countries
File(s)
Author(s)
Type
Journal Article
Abstract
Caesarean delivery (CD) may reduce placental transfusion and cause poor iron-related haematological indices in the neonate. We aimed to explore the association between CD and anaemia in children aged <5 years utilising data from Demographic and Health Surveys conducted between 2005 and 2015 in 45 low- and middle-income countries (N = 132,877). We defined anaemia categories based on haemoglobin levels, analysed each country's data separately using propensity-score weighting, pooled the country-specific odds ratios (ORs) using random effects meta-analysis, and performed meta-regression to determine whether the association between CD and anaemia varies by national CD rate, anaemia prevalence, and gross national income. Individual-level CD was not associated with any anaemia (OR 0.95, 95% confidence interval (CI) [0.86, 1.06]; I2 = 40.2%), mild anaemia (OR 0.91, 95% CI [0.81, 1.02]; I2 = 24.8%), and moderate/severe anaemia (OR 0.97, 95% CI [0.85, 1.11]; I2 = 47.7%). CD tended to be positively associated with moderate/severe anaemia in upper middle-income countries and negatively associated with mild anaemia in lower middle-income countries; however, meta-regression did not detect any variation in the association between anaemia and CD by the level of income, CD rate, and anaemia prevalence. In conclusion, there was no evidence for an association between CD and anaemia in children younger than 5 years in low- and middle-income countries. Our conclusions were consistent when we looked at only countries with CD rate >15% with data stratified by individual-level wealth status and type of health facility of birth.
Date Issued
2017-10-19
Date Acceptance
2017-09-09
Citation
Maternal and Child Nutrition, 2017, 14 (2)
ISSN
1740-8709
Publisher
Wiley
Journal / Book Title
Maternal and Child Nutrition
Volume
14
Issue
2
Copyright Statement
© 2017 John Wiley & Sons Ltd. This is the peer reviewed version of the following article: Wilunda C, Yoshida S, Blangiardo M, Betran AP, Tanaka S, Kawakami K. Caesarean delivery and anaemia risk in children in 45 low- and middle-income countries. Matern Child Nutr. 2017;e12538., which has been published in final form at https://dx.doi.org/10.1111/mcn.12538. This article may be used for non-commercial purposes in accordance With Wiley Terms and Conditions for self-archiving.
Subjects
anaemia
caesarean section
child nutrition
demographic and health survey
haemoglobin
low- and middle-income countries
1111 Nutrition And Dietetics
Nutrition & Dietetics
Publication Status
Published
Article Number
e12538
Date Publish Online
2017-10-19