A potential link between pre-labor cesarean delivery and childhood leukemia exists, according to researchers from the University of Minnesota.
The analysis involved more than 33,500 subjects and covered 13 studies using information from the Childhood Leukemia International Consortium. The data included more than 8,600 cases of acute lymphobastic leukemia (ALL), a cancer of the blood and bone marrow where the latter makes immature lymphocytes – a type of white blood cell – in excess.
The team found no link between emergency c-sections and the type of childhood leukemia in question, also known as acute myeloid leukemia (AML). However, they observed a 23 percent increase in AML risk in all children born via pre-labor c-sections.
Study co-lead author Erin Marcotte said that while the link between overall cesarean delivery and childhood leukemia would not be considered statistically significant, it was notable to find an association between pre-labor c-sections and the condition.
While there is a range of likely reasons for the enhanced risk, the researchers suspected that it may be because the children’s immune systems did not properly adapt at birth.
Marcotte said the cortisol or stress-related aspect may be the most likely explanation for the link. Probably less significant, she added, is the bacterial colonization in the newborn’s body that typically starts during vaginal delivery – and absent during cesarean births.
Co-lead author Logan Spector also favored cortisol exposure as a primary factor for the association, since doctors use similar compounds in treating ALL.
“Thus, our working hypothesis is that cortisol exposure at birth may eliminate these pre-leukemic cells,” he adds.
The team deemed the strength of the link in their findings as comparable to other studies that delved on cesarean delivery and other childhood diseases such as asthma and type 1 diabetes.
The findings were published in the journal Lancet Hematology.
In November, a separate study published in JAMA showed a higher rate of disease – such as type 1 diabetes and irritable bowel syndrome – among kids born by planned c-sections than those born through an emergency c-sections or vaginal delivery.
Meanwhile, potential risk factors for ALL include X-ray exposure before birth, chromosomal changes, or the presence of certain genetic disorders such as Down syndrome. Signs and symptoms, on the other hand, include fever, easy bruising or bleeding, bone or joint pain, and pain-free lumps in parts like the neck and underarm.
Physical examination, blood chemistry test, and biopsy are among the methods employed to diagnose this childhood leukemia.
