Delivery mode and future cardiac morbidity of the offspring - a sibling analysis

Ahmad Essa, Asnat Walfisch, Eyal Sheiner, Tamar Wainstock

Research output: Contribution to journalMeeting Abstract


Cesarean delivery (CD) was recently suggested to be associated with several long-term health implications in offspring. Previous studies have, however, been hindered by limited control for confounders. In this study we aimed to investigate the association between delivery mode and cardiac health of the offspring while employing sibling analysis theme in order to maximize confounder control.

Study Design
A prospectively analyzed population-based cohort study was performed, including all sibling deliveries occurring between 1991-2014 at a regional tertiary medical center. The study included 13,516 individuals (6758 siblings pairs): the first born was via vaginal delivery (VD) and the second via CD. Each siblings pair was considered a matched set, with the aim to perform a within-family analysis. CD was considered the exposure and VD the comparison. The risk for long-term cardiac morbidity in offspring was based on the hospital’s pediatric database and a pre-defined set of ICD-9 code list associated with offspring hospitalizations. Only the first cardiac related hospitalization for each child up to the age of 18 years was included. A Kaplan–Meier survival curve was used to compare the cumulative cardiac morbidity incidence and a McNemar univariate analysis to compare total and selected pediatric cardiac related hospitalizations in offspring according to delivery mode.

No significant association was found between delivery mode and later rates of cardiac related hospitalizations, both for the total rates as well as for specific cardiac disorders (OR=1.02; 95%CI 0.7-1.5, p=0.999; Table). The Kaplan-Meier survival curve showed comparable cumulative rates in both groups (log rank p = 0.151; Figure).

Cesarean delivery per se does not appear to significantly impact on future cardiac health of the offspring, while employing a sibling analysis and minimizing confounding variables.
Original languageEnglish GB
Pages (from-to)S112-S112
JournalAmerican Journal of Obstetrics and Gynecology
Issue number1.Supplement
StatePublished - Jan 2020


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