{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T23:29:41Z","timestamp":1792798181735,"version":"4.5.0"},"reference-count":44,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2015,5,24]],"date-time":"2015-05-24T00:00:00Z","timestamp":1432425600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Erasmus Medical Centre, Rotterdam"},{"DOI":"10.13039\/501100001828","name":"Erasmus University Rotterdam","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100001828","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100001826","name":"Netherlands Organization for Health Research and Development","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100001826","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Lung Foundation Netherlands","award":["3.2.12.089"],"award-info":[{"award-number":["3.2.12.089"]}],"id":[{"id":"https:\/\/ror.org\/04gmab760","id-type":"ROR","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pediatric Allergy Immunology"],"published-print":{"date-parts":[[2015,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      Previous studies suggest that caesarean section may influence the risk of childhood asthma. We examined the associations of different modes of delivery with childhood wheezing patterns, asthma, fractional exhaled nitric oxide (Fe\n                      <jats:styled-content style=\"fixed-case\">NO<\/jats:styled-content>\n                      ) and airway interrupter resistance (Rint) up to school age.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This study among 6,128 children was embedded in a population\u2010based prospective cohort study. Information on mode of delivery was obtained from midwives and hospital registries. Wheezing patterns from birth onwards and ever physician\u2010diagnosed asthma at age 6\u00a0yr were assessed by questionnaires. Fe\n                      <jats:styled-content style=\"fixed-case\">NO<\/jats:styled-content>\n                      and Rint were measured at age 6\u00a0yr. We used multivariate polynomial, logistic and linear regression models.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Compared with vaginal delivery, caesarean section was associated with increased risks of early and persistent wheezing up to school age [odds ratios (95% confidence interval): 1.36 (1.06, 1.75) and 1.73 (1.24, 2.40), respectively]. The effect sizes of elective and emergency caesarean section with wheezing outcomes were similar. Only elective caesarean section was associated with a higher Fe\n                      <jats:styled-content style=\"fixed-case\">NO<\/jats:styled-content>\n                      level [sympercent (95%\n                      <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n                      ): 12.7 (0.6, 24.8)]. We did not observe associations of mode of delivery with asthma or Rint. Also, vacuum\u2010 or forceps\u2010assisted vaginal delivery was not associated with any asthma or related outcome.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      Both elective and emergency caesarean sections are associated with increased risks of early and persistent wheezing up to school age. This might be explained by increased airway inflammation reflected by higher Fe\n                      <jats:styled-content style=\"fixed-case\">NO<\/jats:styled-content>\n                      levels.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/pai.12385","type":"journal-article","created":{"date-parts":[[2015,4,4]],"date-time":"2015-04-04T03:02:28Z","timestamp":1428116548000},"page":"330-336","source":"Crossref","is-referenced-by-count":24,"title":["Mode of delivery and childhood fractional exhaled nitric oxide, interrupter resistance and asthma: the Generation R study"],"prefix":"10.1111","volume":"26","author":[{"given":"Annemaria C.","family":"van Berkel","sequence":"first","affiliation":[{"name":"The Generation R Study Group Erasmus Medical Center Rotterdam The Netherlands"},{"name":"Division of Respiratory Medicine Department of Paediatrics Erasmus Medical Center Rotterdam The Netherlands"},{"name":"Department of Epidemiology Erasmus Medical Center Rotterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Herman T.","family":"den Dekker","sequence":"additional","affiliation":[{"name":"The Generation R Study Group Erasmus Medical Center Rotterdam The Netherlands"},{"name":"Division of Respiratory Medicine Department of Paediatrics Erasmus Medical Center Rotterdam The Netherlands"},{"name":"Department of Epidemiology Erasmus Medical Center Rotterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincent W. V.","family":"Jaddoe","sequence":"additional","affiliation":[{"name":"The Generation R Study Group Erasmus Medical Center Rotterdam The Netherlands"},{"name":"Department of Epidemiology Erasmus Medical Center Rotterdam The Netherlands"},{"name":"Department of Paediatrics Erasmus Medical Center Rotterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irwin K.","family":"Reiss","sequence":"additional","affiliation":[{"name":"Division of Neonatology Department of Paediatrics Erasmus Medical Center Rotterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Romy","family":"Gaillard","sequence":"additional","affiliation":[{"name":"The Generation R Study Group Erasmus Medical Center Rotterdam The Netherlands"},{"name":"Department of Epidemiology Erasmus Medical Center Rotterdam The 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