Children born via planned caesarean section may have a slightly increased risk of developing Acute Lymphoblastic Leukaemia (ALL) later in life, according to a Swedish study published in the International Journal of Cancer.
Researchers from Karolinska Institutet analysed health data from nearly 2.5 million children born in Sweden between 1982–1989 and 1999–2015. Of these, around 376,000 were born by C-section, with nearly 1,500 children eventually diagnosed with leukaemia.
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When researchers separated planned (elective) C-sections from emergency ones using Sweden’s Medical Birth Register, they found a 21% higher risk of ALL in children born by planned C-section compared to those born vaginally. For the most common subtype, B-cell ALL, the risk increased by 29%.
Lead researcher, Dr. Christina-Evmorfia Kampitsi, emphasised that the relative increase in risk is notable, but the overall risk remains very low. “In Sweden, between 50 and 70 children are diagnosed with B-ALL each year. The excess risk from planned C-sections likely accounts for about one additional case per year,” she noted.
The increased risk appeared more pronounced in boys and younger children and remained even after accounting for other maternal and child health factors.
The researchers suggest that early-life immune system development could be influenced by the absence of natural birth stress and microbial exposure. Contrary to emergency C-sections, which usually start with labour and provide partial exposure to vaginal bacteria, planned C-sections are performed before labour begins, limiting the baby’s microbial exposure and stress response, both of which are believed to play a role in immune development.
This theory may also explain why earlier research has linked planned C-sections to higher risks of asthma, allergies, and type 1 diabetes.
However, Dr. Kampitsi clarified that the research isn’t intended to cause panic. “C-sections are vital and often life-saving. These findings should not cause anxiety for mothers needing medically indicated procedures. But we may need to reflect more critically on non-medically necessary elective C-sections.”
