Takanori Suzuki, n/a
Research Fellow
The Hospital for Sick Children
Toronto, Canada
IMPORTANCE: Kawasaki disease (KD) is an acute systemic vasculitis that primarily affects children in developed countries, often leading to acquired heart disease. It has been suggested that the onset of KD is associated with infections and various environmental factors. However, there is limited research on whether delivery type plays a role in the development of KD.
Objective: This study aims to investigate whether cesarean sections (CS) or vaginal deliveries (VD) are associated with the onset of KD, using a large administrative claims database in Japan.
DESIGN, SETTING, AND PARTICIPANTS This study is a nested case-control study using the JMDC Claims Database from January 2005 to December 2021. Information on children delivered by CS or vaginal VD and their mothers was collected from the database. Among the source population, we identified patients with KD as cases. Next, in every case, we randomly selected controls with no previous history of KD based on a risk set sampling technique. Each case was matched with four controls with the same sex, age, and time of registration in the database. We then examined the association between delivery type and KD using multivariable conditional logistic regression analysis.
MAIN OUTCOMES: We defined the primary outcome, KD, based on specific criteria.
RESULT: In the 326,867 deliveries, 67,098 were identified as CS (20.5%). In the multivariable analysis, the onset of KD was associated with CS (odds ratio [OR], 1.15; 95% confidence interval [CI], 1.05–1.26], the presence of siblings (OR, 1.12; 95%CI, 1.04–1.22), lower birth weight (OR, 1.22; 95% CI, 1.00–1.48).
CONCLUSIONS AND RELEVANCE: The risk of developing KD may be influenced by delivery type (CS or VD), low birth weight, and presence of siblings.