Cesarean birth is not associated with early childhood body mass index

Abstract

SummaryCesarean birth leads to a markedly different microbiome compared to vaginal birth, and the microbiome has been implicated in childhood obesity. Among mothers who had a previous cesarean, we compared anthropometry of 3-to 6-year-old children who were subsequently born by cesarean section versus vaginal birth. This large population-based study involved linking de-identified administrative perinatal and anthropometric data. Children's weight and height were collected at community-based clinics and converted to age-and sex-adjusted z-scores of height-for-age (HFAz), weight-for-age (WFAz) and BMI-for-age (BMIz). The average treatment effect (ATE) of cesarean versus vaginal birth was calculated from augmented inverse probability weighted analyses accounting for a wide range of confounding variables. There was little evidence of an effect of cesarean birth on HFAz (ATE = 0.26 95%CI À0.35, 0.87, n = 3993), WFAz (ATE = 0.35, 95%CI À0.19, 0.89, n = 4817) or BMIz (ATE = 0.11, 95%CI À0.25, 0.46, n = 3909). Cesarean section was not associated with anthropometry among children aged 3-6 years.

Change in modifiable maternal characteristics and behaviours between consecutive pregnancies and offspring adiposity: A systematic review

“…Three of the included studies were based on populations in Sweden, 31,34,37 two each in America, 35,38 Australia 29,36 and Brazil 32,33 and one in Scotland 30 . The remaining study 40 used data from five underlying datasets from Australia, Canada and America; one of which was the Collaborative Perinatal Project which was also used by one of the other studies 35 .…”

“…The remaining study 40 used data from five underlying datasets from Australia, Canada and America; one of which was the Collaborative Perinatal Project which was also used by one of the other studies 35 . Three studies included maternal interpregnancy weight change as the exposure, 29,30,37 three examined maternal smoking status, 30,34,40 two considered mode of birth 36,38 and four the length of the interpregnancy interval 31–33,35 . Further study characteristics are detailed in Table 1.…”

“…Quality assessment was also undertaken by two reviewers (EJT and SW). Key strengths and weaknesses of each of the cohort studies 29–38 were formed using the National Heart Lung and Blood Institute assessment tool for observational cohort and cross‐sectional studies 39 . The remaining study is an individual patient data meta‐analysis, 40 and in this instance, we used the PRISMA‐IPD checklist 41 .…”

Effectiveness of a Multifactorial Intervention in the First 1000 Days of Life to Prevent Obesity and Overweight in Childhood: Study Protocol

“…Postnatal: short breastfeeding [44], rapid weight gain in the first year of life [45], excess protein intake [5,46], vitamin D deficiency [47,48], and caesarean section (where there is evidence for and against) [49][50][51].…”

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

“…Subsequent studies also reported inconsistent results. Some studies observed a positive relationship between the delivery mode and offspring weight status [ 20 , 21 ], whereas others found no association [ 22 , 23 ]. Therefore, it remains unclear whether the delivery mode independently predicts the occurrence of obesity in later life.…”