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

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Masukume, Gwinyai
McCarthy, Fergus P.
Baker, Philip N.
Kenny, Louise C.
Morton, Susan M. B.
Murray, Deirdre M.
Hourihane, Jonathan O'B.
Khashan, Ali S.
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Objectives: To 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. Design: Prospective longitudinal cohort study. Setting: Babies After Screening for Pregnancy Endpoints: Evaluating the Longitudinal Impact on Neurological and Nutritional Endpoints cohort. Participants: Infants born to mothers recruited from the Screening for Pregnancy Endpoints study, Cork University Maternity Hospital between November 2007 and February 2011.Outcome measure: Overweight or obese defined according to the International Obesity Task Force criteria.Results: Of 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).Conclusion: At 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.
Caesarean section (CS) , Birth , Body fat percentage , Early childhood , Association
Masukume, G., McCarthy, F.P., Baker, P.N., Kenny, L.C., Morton, S.M., Murray, D.M., Hourihane, J.O.B. and Khashan, A.S., 2019. Association between caesarean section delivery and obesity in childhood: a longitudinal cohort study in Ireland. BMJ open, 9(3), (e025051). DOI:10.1136/bmjopen-2018-025051