Delivery by caesarean section and risk of obesity in preschool age children: a prospective cohort study

Abstract

Objective-To examine whether delivery by caesarean section is a risk factor for childhood obesity.Design-Prospective pre-birth cohort study (Project Viva).Setting-Eight outpatient multi-specialty practices based in the Boston, Massachusetts area.Participants-We recruited women during early pregnancy between 1999 and 2002, and followed their children after birth. We included 1255 children with body composition measured at 3 years of age.Main outcome measures-Body mass index (BMI) z-score, obesity (BMI for age and sex ≥ 95 th percentile), and sum of triceps + subscapular skinfold thicknesses, at 3 years of age.Results-284 children (22.6 percent) were delivered by caesarean section. At age 3, 15.7% of children delivered by caesarean section were obese, compared with 7.5% of children born vaginally. In multivariable logistic and linear regression models adjusting for maternal prepregnancy BMI, birth weight, and other covariates, birth by caesarean section was associated with a higher odds of obesity at age 3 (OR 2.10, 95%CI 1.36 to 3.23), higher mean BMI z-score (0.20 units, 95% CI 0.07 to 0.33), and higher sum of triceps + subscapular skinfold thicknesses (0.94 mm, 95% CI 0.36 to 1.51).Conclusions-Infants delivered by caesarean section may be at increased risk of childhood obesity. Further studies are needed to confirm our findings and to explore mechanisms underlying this association.

Childhood Health and Developmental Outcomes After Cesarean Birth in an Australian Cohort

“…Our goal was to test whether children born by cesarean delivery were more likely to have poor physical and socioemotional outcomes compared with children born vaginally. In line with previous research findings, 10,[12][13][14] we hypothesized that children born by cesarean delivery are more likely to experience asthma and allergies in their early years of life and have a higher BMI compared with their vaginally delivered peers.…”

“…Socioeconomic position was calculated from parental income, education, and occupational prestige 12 ; families with a standardized score at or below the 25th percentile were classified as having a "low" socioeconomic position. Birth factors such as preterm birth, low birth weight, assisted ventilation, or intensive care required after birth, and whether the mothers were breastfeeding at 2 months, were also collected at wave 1.…”

“…[3][4][5][6] For example, studies have reported that children born by cesarean delivery may have increased rates of respiratory illness in their first year of life 5,7,8 and beyond, 9,10 and relationships have also been described with diabetes 11 and child overweight and obesity. 12,13 Notwithstanding these potential adverse associations, children born by cesarean delivery are usually healthy, and it is important to recognize that many factors influence child health other than mode of birth. Thus, an important limitation of many of the studies published to date is a lack of capacity to examine multiple physical and socio-emotional outcomes simultaneously across childhood, and to account for the large number of potential confounding influences.…”

Excess weight and factors associated in preschool of southwest of Bahia

“…22 The results of the present study show an association between the type of delivery and childhood EW, wich children born by cesarean delivery presented 2.59 times (IC95%: 1.11; 6.01) more chances than children born to vaginal delivery. Similar results was found for Huh et al 23 to analyzed a sample with 1225 children born in a health center in the United States, children´s born by surgical delivery presented 2.10 (95% CI: 1.36, 3.23) times the chance to having EW. The mechanism of this association is not elucidated.…”

The effect of medical and operative birth interventions on child health outcomes in the first 28 days and up to 5 years of age: A linked data population‐based cohort study

“…Short‐term adverse health outcomes included jaundice, feeding problems, and hypothermia and often are part of the adaptation of the infant to being outside the uterus 7, 27, 28. The longer‐term adverse health outcomes included asthma, respiratory infections (eg, common cold, pneumonia, bronchitis), gastrointestinal disorders, other infections (eg, sepsis, streptococcus, cystitis), metabolic disorder (eg, hypoglycemia, neonatal diabetes mellitus, diabetes mellitus type 1 or 2, localized adiposity), and eczema, based on the potential effect that mode of birth has on immune‐related diseases 5, 6, 7, 12, 13, 14, 15, 16, 17, 18. An overview of all adverse health outcomes and other covariates with corresponding ICD‐10‐AM codes are presented in the Supporting Information.…”