Young children born by pre-labor cesarean delivery may be at an increased risk of childhood acute lymphoblastic leukemia (ALL), according to a study published in The Lancet Haematology.1

Researchers led by Erin Marcotte, PhD, of the University of Minnesota pooled data across 9 countries from 13 case-control studies through the Childhood Leukemia International Consortium, which included births from 1970 to 2013.

In total, they analyzed 8655 patients with ALL and 1292 patients with acute myeloid leukemia (AML) who were born from cesarean delivery. Patients were matched with 23 351 control cases.

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The researchers found that odds ratios for all indications of cesarean delivery and ALL was 1.06, which was found to be significant for pre-labor cesarean delivery and ALL.

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Emergency cesarean delivery was not found to be associated with ALL; and AML was not associated with cesarean, prelabor cesarean, and emergency cesarean delivery.

“Our results suggest an increased risk of childhood ALL after prelabor caesarean [sic] delivery,” the authors concluded. “If this association is causal, maladaptive immune activation due to an absence of stress response before birth in children born by prelabor caesarean delivery could be considered as a potential mechanism.”


  1. Marcotte EL, Thomopoulos TP, Infante-Rivard C, et al. Caesarean delivery and risk of childhood leukaemia: a pooled analysis from the Childhood Leukemia International Consortium (CLIC) [published online ahead of print February 26, 2016]. Lancet Haematol. doi: 10.1016/S2352-3026(16)00002-8.