Association between caesarean section delivery and obesity in childhood: a longitudinal cohort study in Ireland

Abstract

ObjectivesTo investigate the association between caesarean section (CS) birth and body fat percentage (BF%), body mass index (BMI) and being overweight or obese in early childhood.DesignProspective longitudinal cohort study.SettingBabies After Screening for Pregnancy Endpoints: Evaluating the Longitudinal Impact on Neurological and Nutritional Endpoints cohort.ParticipantsInfants born to mothers recruited from the Screening for Pregnancy Endpoints study, Cork University Maternity Hospital between November 2007 and February 2011.Outcome measureOverweight or obese defined according to the International Obesity Task Force criteria.ResultsOf the 1305 infants, 362 (27.8%) were delivered by CS. On regression analysis, BF% at 2 months did not differ significantly by delivery mode. Infants born by CS had a higher mean BMI at 6 months compared with those born vaginally (adjusted mean difference=0.24; 95% CI 0.06 to 0.41, p value=0.009). At 2 years, no difference was seen across the exposure groups in the risk of being overweight or obese. At 5 years, the association between prelabour CS and the risk of overweight or obesity was not statistically significant (adjusted relative risk ratio, aRRR=1.37; 95% CI 0.69 to 2.69) and the association remained statistically nonsignificant when children who were macrosomic at birth were excluded from the model (aRRR=0.86; 95% CI 0.36 to 2.08).ConclusionAt 6 months of age, children born by CS had a significantly higher BMI but this did not persist into future childhood. There was no evidence to support an association between mode of delivery and long-term risk of obesity in the child.

Investigating Stress Response during Vaginal Delivery and Elective Cesarean Section through Assessment of Levels of Cortisol, Interleukin 6 (IL-6), Growth Hormone (GH) and Insulin-Like Growth Factor 1 (IGF-1)

“…Published data on animal studies concur that increased GH levels are associated with dysfunction of the adipose tissue and increased weight during the first three-to-six months [47]. Further to that, children born via CS tend to present with an increased weight in comparison to VD neonates [48]. Whether this phenomenon may be attributed to elevated GH levels in umbilical cord blood of elective CS neonates remains to be evaluated by future studies.…”

Caesarean section delivery and childhood obesity in a British longitudinal cohort study

“…Studying the associations underlying the role of CS with childhood obesity is important, given the global increase in CS rates and the epidemic of childhood obesity. [28–30] We recently performed two studies[10, 31] to address some of the limitations of previous reports, but both studies only followed-up offspring to age five years.…”

“…In this study we used a similar approach to our previous work but with a different and larger dataset and much longer follow-up. This included analysis of the link between CS birth and body fat percentage (BF%) as previously performed,[31] on the basis that adiposity may be a more accurate measure of obesity than BMI. [32]…”

Association of Cesarean Birth with Body Mass Index Trajectories in Adolescence

“…In our research, the two groups, "progressive obesity" trajectory and "obesity to healthy weight" trajectory, differed in the association with Cesarean delivery, despite their similarly higher weight status at the beginning of the study. This might explain some studies did not find positive relationship between Cesarean birth and obesity [32]. Therefore, a better understanding of the trajectories of those who develop obesity or those who had high BMI in adolescence but did not become obese in late adolescence was particularly important from a public health perspective.…”