Neonatal Thrush Is Not Associated with Mode of Delivery

Purpose: Thrush is an opportunistic infection of the buccal cavity by the organism Candida albicans. It is most commonly seen in infants and becomes relatively uncommon between 6 to 9 months of age implying the infection is possibly dictated by risk factors present at or around the time of birth. The objective of this study is to determine if there is an association between the development of thrush and cesarean delivery, as we hypothesize.

Methods: Neonatal records were obtained through retrospective chart review of the past 10 years from an outpatient clinic and hospital records in Sandusky Ohio. ICD 9 and 10 codes for thrush and well child visit were used to identify patients. Statistical analysis performed on the data included: multivariable logistic regression, χ² test of association, and nonparametric χ² test of goodness-of-fit.

Results: A total of 636 patient records were reviewed, with 127 having a diagnosis of thrush and 509 without the diagnosis. A multivariable logistic regression indicated that during the first year of life, children born by cesarean section were no more likely to develop thrush compared with those born by vaginal delivery, controlling for age and sex of the neonate as well as parity and group B streptococcus status of the mother.

Conclusion: This study demonstrated that there is no significant correlation between the mode of delivery and the development of thrush. It is reasonable to conclude that of the many factors associated with neonatal thrush development, mode of delivery is likely not one of them.