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

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dc.contributor.author Masukume, Gwinyai
dc.contributor.author Khashan, Ali S.
dc.contributor.author Morton, Susan M. B.
dc.contributor.author Baker, Philip N.
dc.contributor.author Kenny, Louise C.
dc.contributor.author McCarthy, Fergus P.
dc.date.accessioned 2019-12-04T10:54:16Z
dc.date.available 2019-12-04T10:54:16Z
dc.date.issued 2019-10-30
dc.identifier.citation Masukume, G., Khashan, A. S., Morton, S. M. B., Baker, P. N., Kenny, L. C. and McCarthy, F. P. (2019) 'Caesarean section delivery and childhood obesity in a British longitudinal cohort study', PLOS ONE, 14(10), e0223856. (13pp.) doi: 10.1371/journal.pone.0223856 en
dc.identifier.volume 13 en
dc.identifier.issued 10 en
dc.identifier.startpage 1 en
dc.identifier.endpage 13 en
dc.identifier.uri http://hdl.handle.net/10468/9315
dc.identifier.doi 10.1371/journal.pone.0223856 en
dc.description.abstract Background: Several studies reported an association between Caesarean section (CS) birth and childhood obesity. However, there are several limitations in the current literature. These include an inability to distinguish between planned and emergency CS, small study sample sizes and not adjusting for pre-pregnancy body-mass-index (BMI). We examined the association between CS delivery and childhood obesity using the United Kingdom Millennium Cohort Study (MCS). Methods: Mother-infant pairs were recruited into the MCS. Use of sampling weights ensured the sample was representative of the population. The exposure was categorised as normal vaginal delivery (VD) [reference], assisted VD, planned CS and emergency CS. Childhood obesity prevalence, at age three, five, seven, eleven and fourteen years was calculated using the International Obesity Taskforce criteria. Mixed-effects linear regression models were fitted with associations adjusted for several potential confounders like maternal age, pre-pregnancy BMI, education and infant macrosomia. Linear regression models were fitted evaluating body fat percentage (BF%), at age seven and fourteen years. Results: Of the 18,116 infants, 3872 (21.4%) were delivered by CS; 9.2% by planned CS. Obesity prevalence was 5.4%, 5.7%, 6.5%, 7.1% and 7.6% at age three, five, seven, eleven and fourteen years respectively. The mixed-effects linear regression model showed no association between planned (adjusted mean difference = 0.00; [95% confidence interval (CI) -0.10; 0.10], p-value = 0.97) or emergency CS (adjusted mean difference = 0.08; [95% CI -0.01; 0.17], p-value = 0.09) and child BMI. At age seven years, there was no association between planned CS and BF% (adjusted mean difference = 0.13; [95% CI -0.23; 0.49]); there was no association at age fourteen years. Conclusions: Infants born by planned CS did not have a significantly higher BMI or BF% compared to those born by normal VD. This may suggest that the association, described in the literature, could be due to the indications/reasons for CS birth or residual confounding. en
dc.format.mimetype application/pdf en
dc.language.iso en en
dc.publisher Public Library of Science en
dc.rights ©2019 Masukume et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. en
dc.rights.uri http://creativecommons.org/licenses/by/4.0/ en
dc.subject Caesarean section (CS) en
dc.subject Childhood obesity en
dc.subject Britain en
dc.title Caesarean section delivery and childhood obesity in a British longitudinal cohort study en
dc.type Article (peer-reviewed) en
dc.internal.authorcontactother Fergus McCarthy, Department of Obstetrics and Gynaecology and INFANT Research Centre, University College Cork, Cork, Ireland. +353-21-490-3000 Email:fergus.mccarthy@ucc.ie en
dc.internal.availability Full text available en
dc.description.version Published Version en
dc.contributor.funder Science Foundation Ireland en
dc.description.status Peer reviewed en
dc.identifier.journaltitle PLOS ONE en
dc.internal.IRISemailaddress fergus.mccarthy@ucc.ie en
dc.identifier.articleid e0223856 en
dc.relation.project info:eu-repo/grantAgreement/SFI/SFI Research Centres/12/RC/2272/IE/Irish Centre for Fetal and Neonatal Translational Research (INFANT)/ en
dc.identifier.eissn 1932-6203


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©2019 Masukume et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Except where otherwise noted, this item's license is described as ©2019 Masukume et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
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