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Caesarean Section, Maternal Stress & Phototherapy

This sub-project is exploring associations with eczema, food allergy and wheeze in children of the ORIGINS cohort.

Over the past 20 years, there has been a significant rise in the number of caesarean sections worldwide, with the rate in Australia increased from 24% in 2004 to 34% in 2022. 

However, studies have suggested that children born by caesarean have an increased risk of developing diseases such as obesity, eczema and asthma. The same trend has also been found in babies who received phototherapy for jaundice.

Anxiety, depression and stressful life events experienced by a mother during the perinatal period have also been linked to allergic diseases in her children. It is thought that caesarean section and maternal stress independently affect bacterial, stress hormone and protein levels that are all essential for the development of a healthy immune system.

This research aims to evaluate associations between caesarean delivery, maternal stress and allergic disease outcomes at 1 and 3 years of age within the ORIGINS cohort.

The objectives of this study are:

  1. To describe the prevalence of caesarean section in the ORIGINS cohort, including indications and elective versus non-elective status.
  2. To describe the prevalence of maternal stress both in pregnancy and postpartum in the ORIGINS cohort, identified through medical history and mental health questionnaires.
  3. To describe the prevalence of jaundice in ORIGINS offspring, and rates of phototherapy (including duration and intensity of therapy).
  4. To compare baseline information between ORIGINS mothers with respect to objectives 1 and 2, specifically: maternal age, ethnicity, maternal education, postcode, gestational age, parity, medical history (including gestational diabetes), allergies, smoking, weight gain, pre-pregnancy body mass index (BMI) and maternal antibiotic exposure.
  5. To describe the prevalence of allergic disease in the ORIGINS offspring with respect to objectives 1 and 2, with specific outcomes being eczema, allergy sensitisation and wheeze at 1 and 3 years of age, with adjustments for the above maternal characteristics outlined in objective 3 as well as paternal history of atopic disease, pets, smoking (household or environmental exposure), infant sex, birthweight, mode of feeding, introduction of solids and infant antibiotic exposure.
  6. To compare findings with those from similar cohort studies, including from the GUSTO (Growing Up in Singapore Towards healthy Outcomes) cohort.

The findings would assist healthcare professionals and families in making informed decisions about birthing methods and better manage maternal stress in pregnancy and postpartum.

The overall aim is to reduce the rate of allergic diseases in children in the future.

Investigators 

  • Dr Catherine Nyugen, The Kids Research Institute Australia
  • Professor Desiree Silva, ORIGINS Co-Director, The Kids Research Institute Australia
  • Dr Meera Thalayasingam, Perth Children's Hospital
  • Dr Benedicta Itotoh, Perth Children's Hospital
  • Dr Sarah Whalan, ORIGINS Data Manager, The Kids Research Institute Australia 
  • Associate Professor Debbie Palmber, The Kids Research Institute Australia
  • Dr Jackie Davis, ORIGINS Co-Director, The Kids Research Institute Australia