Does a cesarean section affect the health of a child born in this way? A topic that has been frequently discussed by neonatologists and pediatricians in the last decade was presented a few days ago at the “Panhellenic Conference of Child and Adolescent Medicine”, which was organized in the Portaria of Pelion.

Suggestion for the topicLong-term outcomes of newborns born by caesarean section” she did Joanna GriveyaProfessor of Pediatrics and Neonatology at the Faculty of Medicine of the University of Thessaly and Director of the Pediatric Clinic at the University Hospital of Larissa.

In a conversation with “K”, she says that caesarean section is the most common operation performed by women of reproductive age, despite the clear instructions of the doctor. WHERElike a caesarean section they should not exceed 15% of suppliesn. Unfortunately, in many Western countries it is abused, with rates in some cases even approaching 60% (compared to natural childbirth). According to Ms. Griveyathe only exception to the “rule” are the Scandinavian countries, which in recent years have come closer and closer to the percentage set by WHEREthrough organized efforts to reduce the number of caesarean sections.

As for our country, its data ELSTAT show that in Greece 2020 normal deliveries were 34 783 and caesarean section 48 833, while the mode was not declared in 1148 birth. 2021 normal deliveries were 33 619C-section 51 594while the mode was not declared in 133 cases.

Problems in children reported by international studies

But why do they persist? neonatologists Are there so many pediatricians in natural childbirth? “First of all, because we know it’s safer for both mother and baby,” says Mrs. Wilson. Griveya and adds: “We must not forget that a caesarean section is an operation, although the misconception is often cultivated that this is a safer way to give birth.”

According to a series of macroscopic, epidemiological studies conducted both in European countries such as Denmark, Germany, and in USA, over the past decade (and which have been presented Mr Grivea at a recent conference) there are two main differences between babies born vaginally and babies born by caesarean section.

Lowest prices cortisol that in children born by caesarean section, it can lead to an increase in the incidence of complications during the adaptation of the newborn to the extrauterine environment, such as transient tachypnea and pulmonary hypertension.

“Studies show that babies born by caesarean section are more likely to be admitted to neonatal intensive care units,” says Ms K. Greavey.

Even at 39 weeks, a baby who is delivered by elective caesarean section is twice as likely to have breathing problems as a baby born vaginally, she said. At 38 weeks, this has a triple chance.

Also, according to studies, on the sixth day of life, only 20% of newborns with a caesarean section have the same weight as at birth, in contrast to newborns with normal births, where this percentage reaches 40%.

“The second thing the research focuses on is that in DNA of these children and in particular in white blood cells, which we don’t know how long they exist,” Ms. Griveya and reports that a large number of publications are devoted to his participation microbiome mothers in ideal neonatal colonization. She explains what it means.

“Because babies who have had a caesarean section do not produce the hormones that are produced when a normal baby is born, this changes microbiome intestines. A newborn during normal delivery is colonized by the microbial flora of the mother’s vagina and intestines. Within a few days gastrointestinal tract his system was colonized with large amounts of E. coli and streptococcus and then with breastfeeding, production is also stimulated anaerobes microbes. Also in mother’s milk there are factors that enhance the production of dominant microbes in the intestines of a newborn born during normal childbirth. These bacteria play an important role in the regulation of the immune system. They influence the level NK (natural killers), regulate the population of T-lymphocytes, their secretion IgA antibodies and synthesis of pro-inflammatory cytokines.

So if a child born by caesarean section grows up, eats poorly, does not breastfeed or takes a lot of medication, he will have additional factors and a greater chance, at an older age, of developing certain diseases, such as asthma, inflammatory bowel disease, allergies and obesity.”

OUR Athanasius mijosProfessor pediatrics-infectious diseases at the First Pediatric Clinic of the Medical School of Athens, he in turn tells “K” that although the issue of the effect of caesarean section on children born in this way has been studied for many years, scientists and pediatricians are concerned about the large number of planned caesarean sections, but the situation is not improving . He called more important than the consequences of caesarean section, changes in microbiome intestines.

In fact, given that the programming of the immune system starts from the neonatal age, according to Ms. Griveyaif the baby already has a pathological genotype, then such exogenous factors as caesarean section, artificial feeding or frequent use of antibiotics will “wake up” these pathological elements. As she explains: “A possible problem, such as an autoimmune one, will manifest itself faster and give a clinical picture faster.”

RS. Griveya considers, however, that the problem must begin arranged: “At the first stage, we are interested in reducing the frequency of planned caesarean sections, which are performed in women who have given birth to their first child in this way, with the fetus in the head projection, i.e. in the right position inside the uterus, and this is also a period. This is the most typical case when there is no need to do a caesarean section. You know, if in Greece gynecologists were controlled, as it happens, for example, in USA and they had to document why a baby is born before 39 weeks without an absolute indication of a c-section, our percentage may not have been that high.”

Why is a planned caesarean section a problem?

First, according to Mr. Griveyascientists are not interested in all caesareans, but planned ones. As the professor explains, in Greece there is no monitoring of the frequency of planned caesarean sections, and there is no publicly available data.

There are many reasons why there is a high rate of caesarean sections in Greece. Spiridula Neophytemidwife and head b’ Obstetrics-Clinic of Gynecology at the University Hospital Areteio. In the maternity hospital in question, a birth history is kept, which explains the reasons for each caesarean section.

“In some cases, the reasons are objective. In other words, a caesarean section should be done due to force majeure, for the safety of the mother or fetus, ”explains the madam. Neophyte and continues: “In many other cases, a caesarean section is actually planned. Often they are carried out at the request of the woman herself, especially if she is older. However, the fear of childbirth or the notion that a caesarean section is a quick and relaxing solution is often cultivated by gynecologists and leaves women unaware or misinformed.

In addition, elective caesarean section is regularly performed in our country, and when a woman has already given birth to her first child in this way, the next birth is automatically performed by caesarean section, despite European and world recommendations that this should not happen, except in cases when there is some strong indication. So there is ignorance in that part too.

State maternity hospitals are not without responsibility. And there the birth is planned, for “the day when the bed or room is empty.”

Also, the number of induced births is constantly increasing so that gynecologists can plan their time, not wait for a child, not work on weekends, etc. However, this problem significantly increases the chances that the outcome of childbirth will lead to a caesarean section.”

It is noted that in 2017, the organization of the obstetric service in Greece was under the scrutiny of scientists from the World Health Organization who visited our country and submitted a report to the Greek Ministry of Health describing the system created for “convenience”. those who are involved but expose the scientific community, which aims to explain why it is “difficult” for Greek women to have a child naturally.

In particular, according to him EOPYYwho referred to this output, 56.8% of births in our country are performed by caesarean section, the percentage is not much different from the private to the public sector. 58.7% of births in private clinics are by caesarean section and, accordingly, in public hospitals 53.8%.. Although the number of public hospitals providing OB/GYN services is greater than the number of private providers (64 public hospitals versus 43 private clinics), 61.6% of births take place in private clinics.