Association between Cesarean Section and Weight Status in Chinese Children and Adolescents: A National Survey

Abstract

Previous research on the association between cesarean section (CS) and childhood obesity has yielded inconsistent findings. This study assessed the secular trend of CS and explored the relationship between CS and the risks of overweight and obesity in Chinese children and adolescents. Data came from a national multicenter school-based study conducted in seven provinces of China in 2013. Covariate data including weight, height and delivery mode were extracted. Poisson regression was applied to determine the risk ratios (RRs) and 95% confidence intervals (CIs) for the risks of overweight and obesity associated with the delivery mode. A total of 18,780 (41.2%) subjects were born by CS between 1997 and 2006. The rate of CS increased from 27.2% in 1997 to 54.1% in 2006. After adjusting for major confounders, the RRs (95% CI) of overweight and obesity among subjects born by CS were 1.21 (1.15 to 1.27) and 1.51 (1.42 to 1.61), respectively. Similar results were observed in different subgroups stratified by sex, age, and region. In summary, the CS rate increased sharply in China between 1997 and 2006. CS was associated with increased risks of overweight and obesity in offspring after accounting for major confounding factors.

The relationship between maternal serum apelin-36 level and anthropometric indices up to 18 months after birth; A cohort Study

“…[28][29][30] In addition, other research reveal that children delivered by cesarean had an approximately 50% higher risk of being overweight throughout childhood compared with children delivered vaginally. [33][34][35] Given the wide role of apelin in obesity and metabolic syndrome 10,20 as well as the importance of this hormone as a powerful angiogenic factor for normal vascular development and considering positive upregulation of this hormone by Sexsteroids, insulin, TNF-α (Tumor Necrosis-Factor Alpha) and growth hormone VD 16,18 as well as relationship investigated in our study, it can be concluded that this hormone can have a relation with children anthropometric indices.…”

Linkage Between 2 Information Systems: Combined Live Births and Food and Nutrition Surveillance as a Public Health Tool for Investigation of the Determinants of Obesity Among Children and Adolescents in Southern Brazil

“…Mueller et al 20 demonstrated that children born by cesarean delivery had 46% higher odds of developing obesity at 7 years of age, irrespective of antibiotic exposure during the prenatal period. In a multicenter Chinese study of 18 780 children, Liang et al 30 found a 51% greater probability of obesity among children born by cesarean delivery, irrespective of birth weight, gestational age, maternal age, and educational attainment, despite higher daily intake of meat, fruits, and vegetables and shorter durations of sedentary behavior when compared to children born via vaginal delivery. A prospective cohort study found a 2-fold likelihood of obesity at 3 years of age in children born via cesarean delivery, irrespective of maternal BMI and birth weight.…”

“…32 -34 The authors suggest that the magnitude of this effect may decrease the extent to which children grow, attributing it to increased exposure to an obesogenic environment, wherein factors such as eating habits and physical activity may become more important than the type of birth, which may mask this association between cesarean delivery and later obesity development. 30,34,35…”