Pre-Labor Cesarean Delivery May Increase Risk of Childhood Leukemia: Study

The findings of new research suggests that children may face a higher risk of developing leukemia if they are born by a pre-labor cesarean section, as opposed to delivery vaginal or during an emergency c-section. 

In a study published this week by the medical journal The Lancet Haematology, researchers from the Masonic Cancer Center and the University of Minnesota found that there may be a 23% higher risk of childhood acute lymphoblastic leukemia (ALL) associated with pre-labor c-section delivery.

Researchers analyzed  data on more than 33,000 births from 1970 to 2013, from 13 studies of the Childhood Leukemia International Consortium. The data came from nine different countries, including Canada, Costa Rica, Egypt, France, Germany, Greece, Italy, New Zealand and the United States. The births were analyzed for type of delivery; vaginal, emergency c-section, and pre-labor c-section, or when a mother is full-term but has not begun labor yet, and has c-section to deliver the child.

The study assessed the risk of both acute lymphoblastic leukemia (ALL) and acute myeloid leukemia (AML) among children up to 14 years old. Both forms of childhood leukemia are cancers of the white blood cells, causing the cancerous cells to overproduce and inhibiting the production of normal cells.

Researchers found no link between emergency c-sections and ALL or AML. They also concluded there was no observed correlation between AML and pre-labor c-sections. However, a 23% increased risk of ALL was found in children born through pre-labor c-sections. Researchers hypothesize this is primarily due to improperly adapted immune systems at birth.

Other studies have shown that there may be health risks associated with a lack of exposure to microbiota, which an infant is exposed to in the birth canal, including an asthma risk linked to planned cesarean births.

The microbiota colonization is less likely since ALL was not linked to emergency c-sections as well.

In this case, that is most likely not the cause, researchers speculate. They say the most probably explanation is cortisol, a stress-related mechanism.

Researchers also noted, some children are born with cells that are already on the path to becoming leukemia. They speculate the cortisol exposure at birth may eliminate pre-leukemic cells, since similar compounds are used to treat ALL. This study shows the need for further research concerning leukemia and cesarean births, according to the authors.