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Cesarean baby 15% more likely to become obese
Researchers also found those born vaginally by women who had undergone a previous cesarean delivery, were 31% less likely to become obese compared with those born via cesarean birth immediately following a cesarean birth.
Nearly 1.3 million cesareans are performed each year in the U.S., accounting for one third of all deliveries. While a number of previous studies have suggested a link between cesarean delivery and a higher risk of obesity in offspring, the studies were either too small to detect a clear association or lacked detailed data.
The new analysis included 16 years' worth of data from more than 22,000 young adults in the Growing Up Today Study (GUTS).
Objective To investigate the association between cesarean birth and risk of obesity in offspring.
Design, Setting, and Participants A prospective cohort study was conducted from September 1, 1996, to December 31, 2012, among participants of the Growing Up Today Study, including 22?068 offspring born to 15?271 women, followed up via questionnaire from ages 9 to 14 through ages 20 to 28 years. Data analysis was conducted from October 10, 2015, to June 14, 2016.
Exposure Birth by cesarean delivery.
Results Of the 22?068 offspring (20?950 white; 9359 male and 12?709 female), 4921 individuals (22.3%) were born by cesarean delivery. The cumulative risk of obesity through the end of follow-up was 13% among all participants. The adjusted risk ratio for obesity among offspring delivered via cesarean birth vs those delivered via vaginal birth was 1.15 (95% CI, 1.06-1.26; P = .002). This association was stronger among women without known indications for cesarean delivery (adjusted risk ratio, 1.30; 95% CI, 1.09-1.54; P = .004). Offspring delivered via vaginal birth among women who had undergone a previous cesarean delivery had a 31% (95% CI, 17%-47%) lower risk of obesity compared with those born to women with repeated cesarean deliveries. In within-family analysis, individuals born by cesarean delivery had 64% (8%-148%) higher odds of obesity than did their siblings born via vaginal delivery.
Conclusions and Relevance Cesarean birth was associated with offspring obesity after accounting for major confounding factors. Although additional research is needed to clarify the mechanisms underlying this association, clinicians and patients should weigh this risk when considering cesarean delivery in the absence of a clear indication.
Other Harvard Chan authors involved in the study included lead author Changzheng Yuan, Audrey Gaskins, and Matthew Gillman.
Funding for the study came from grants UM1-CA176726, P30-DK046200, U54- CA155626, T32-DK007703-16, HD066963, HL096905, DK084001, and MH087786 from the National Institutes of Health.
"Association Between Cesarean Birth and Risk of Obesity in Offspring in Childhood, Adolescence, and Early Adulthood," Changzheng Yuan, Audrey J. Gaskins, Arianna I. Blaine, Cuilin Zhang, Matthew W. Gillman, Stacey A. Missmer, Alison E. Field, and Jorge E. Chavarro, JAMA Pediatrics, online September 6, 2016, doi: 10.1001/jamapediatrics.2016.2385
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Nurse preparing patient for a cesarean birth.
Image Credit: Public Domain