Delivery type, birth weight predict onset of Kawasaki disease

Several factors may influence the development of Kawasaki disease (KD) in children, and these include delivery type and birth weight, among others. 

This case-control study utilized the JMDC claims database from January 2005 to December 2021. The investigators obtained data on children born via caesarean section (CS) or vaginal delivery (VD) and their mothers. They identified KD patients from the source population and randomly selected controls with no KD based on sex, age, and registration time, each matched to four controls via risk-set sampling. 

The association between delivery type and KD onset was explored using multivariate conditional logistic regression. The investigators defined KD as the primary outcome based on specific criteria. 

A total of 3,363 pairs of KD patients (n=3,363) and controls (n=13,363) were included in the analysis. A significant difference was noted in the proportions of CS, maternal age, Charlson Comorbidity Index, presence of older siblings, and low birth weight infants between patients and controls. 

Multivariate analysis revealed the following predictors of KD onset: CS (odds ratio [OR], 1.12, 95 percent confidence interval [CI], 1.02—1.24), presence of older siblings (OR, 1.11, 94 percent CI, 1.02—1.21), lower birth weight (1,001 to 2,500 g; OR, 1.22, 95 percent CI, 1.04—1.43), and antibiotic use (OR, 1.12, 95 percent CI, 1.02—1.24). 

“KD onset has been suggested to be associated with infections and various environmental factors,” the investigators said. “However, research on whether the delivery type plays a role in KD development is limited.”