Association of Cesarean Birth with Body Mass Index Trajectories in Adolescence

Abstract

Background: This study aimed to identify patterns of body mass index (BMI) changes in adolescence and to assess whether delivery mode (Cesarean and vaginal delivery) was associated with BMI trajectories. Methods: This study was conducted among 569 adolescents aged 10-15 years that resided in the city of Zibo, China. The height and weight of each participant were repeatedly measured at 10, 11, 12, 13, 14 and 15 years. Group based trajectory modeling (GBTM) was used to estimate BMI change trajectories, and multinomial logistic regression was conducted to evaluate the independent association of delivery mode and BMI trajectory classes. Results: Of the 569 participants, 407 (71.5%) were vaginal deliveries and 162 (28.5%) were Cesarean deliveries. Five distinct long-term BMI trajectories were identified: "persistent healthy weight" (57.5%), "persistent underweight" (6.5%), "obesity to healthy weight" (7.8%), "progressive overweight" (10.6%), "progressive obesity" (17.6%). Adjusted multinomial logistic models revealed a twofold increase in risks between ages 10-15 years of "progressive obesity" trajectory (OR = 2.50, 95% CI: 1.42, 4.41) for children born through Cesarean section compared with vaginal birth. Conclusions: Five distinct long-term BMI trajectories were identified during adolescence in our research, and we confirmed that Cesarean birth was significantly increased the risk of "progressive obesity" trajectory but not the "obesity to healthy weight" trajectory.

Effect of Elective Cesarean Section on Children's Obesity From Birth to Adolescence: A Systematic Review and Meta-Analysis

“…A large amount of evidence supports that obesity during birth and infancy has a great influence on obesity in later life stage, including preschool-age and adolescence (44). Zhou's study had focused on the dynamic changes in children's growth and development and confirmed that CS significantly increased the risk of "progressive obesity" trajectory (OR = 2.50, 95% CI: 1.42, 4.41) at the ages of 10-15 years (45). Due to the limited data, we could not provide powerful findings on the effect of ECS on the occurrence of obesity in adolescents in the current study.…”

Birth by cesarean delivery and central adiposity in adolescents from a birth cohort

“…Most studies on the association between cesarean delivery and obesity have been done including children 4,5,6,17,32,33,34,35,36,37,38 and adults 5,16,39,40,41 . Some studies have been carried out including adolescent individuals 4,5,6,17,42 , but there are few studies conducted with individuals in their late adolescence 4,5,27,29 . This study was carried out with people in this age group because they have already gone through the growth stage and are no longer under the hormonal effects of adolescence, which provide greater deposition of adipose tissue 43 .…”

Associations between socioeconomic status and risk of obesity and overweight among Chinese children and adolescents

“…Due to the differences in body fat percentage between East Asians and Europeans, the definition of overweight or obesity was based on the Chinese standard "Screening for overweight and obesity among school-age children and adolescents", standard number WS/T 586–2018 [ 35 , 36 ]. The process for identifying overweight or obesity in school-aged children and adolescents between the ages of 6 and 18 was described in the standard, together with the technical prerequisites for this procedure.…”