{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,14]],"date-time":"2026-02-14T05:12:54Z","timestamp":1771045974581,"version":"3.50.1"},"reference-count":52,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2015,5,16]],"date-time":"2015-05-16T00:00:00Z","timestamp":1431734400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clin Experimental Allergy"],"published-print":{"date-parts":[[2015,6]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Observationally, delivery by Caesarean section is associated with higher risk of childhood asthma and wheeze in developed Western settings, but associations are less consistent in other settings.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>To examine the association of mode of delivery with hospitalizations for asthma and other wheezing disorders in a developed non\u2010Western setting with high rates of Caesarean section.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Using Cox regression, we examined the adjusted association of mode of delivery with public hospital admissions for asthma, bronchitis, and bronchiolitis (International Classification of Diseases, Ninth Version Clinical Modification 466, 490 and 493) from 9\u00a0days to 12\u00a0years of age in a population\u2010representative prospective birth cohort of 8327 Chinese children in Hong Kong. Confounders included sex, birth and parental characteristics, and socio\u2010economic position (<jats:styled-content style=\"fixed-case\">SEP<\/jats:styled-content>).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Delivery by Caesarean section accounted for 27% of all births and was not clearly associated with hospitalizations for asthma and other wheezing disorders to 12\u00a0years [hazard ratio (<jats:styled-content style=\"fixed-case\">HR<\/jats:styled-content>) 1.11, 95% confidence interval (<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>) 0.91 to 1.36] compared to vaginal delivery. Similarly, there were no clear associations to 2\u00a0years (<jats:styled-content style=\"fixed-case\">HR<\/jats:styled-content>1.07, 95%<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>0.83 to 1.38) or 6\u00a0years (<jats:styled-content style=\"fixed-case\">HR<\/jats:styled-content>1.12, 95%<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>0.91 to 1.37), although we cannot rule out residual confounding by<jats:styled-content style=\"fixed-case\">SEP<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions and Clinical Relevance<\/jats:title><jats:p>We cannot rule out an association, but our findings suggest that the observed associations of delivery by Caesarean section with childhood wheezing disorders may vary with setting and may not be biologically mediated. Further studies with different designs are needed to clarify the role of the microbiome and mode of delivery in the aetiology of asthma and other childhood wheezing disorders.<\/jats:p><\/jats:sec>","DOI":"10.1111\/cea.12548","type":"journal-article","created":{"date-parts":[[2015,4,3]],"date-time":"2015-04-03T18:33:32Z","timestamp":1428086012000},"page":"1109-1117","source":"Crossref","is-referenced-by-count":26,"title":["Mode of delivery and childhood hospitalizations for asthma and other wheezing disorders"],"prefix":"10.1111","volume":"45","author":[{"given":"J. Y. Y.","family":"Leung","sequence":"first","affiliation":[{"name":"School of Public Health Li Ka Shing Faculty of Medicine The University of Hong Kong Hong Kong SAR China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A. 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