Delivery by caesarean section and risk of obesity in preschool age children: a prospective cohort study

Arch Dis Child. 2012 Jul;97(7):610-6. doi: 10.1136/archdischild-2011-301141. Epub 2012 May 23.

Abstract

Objective: To examine whether delivery by caesarean section is a risk factor for childhood obesity.

Design: Prospective prebirth cohort study (Project Viva).

Setting: Eight outpatient multi-specialty practices based in the Boston, Massachusetts area.

Participants: We recruited women during early pregnancy between 1999 and 2002, and followed their children after birth. We included 1255 children with body composition measured at 3 years of age.

Main outcome measures: BMI score, obesity (BMI for age and sex ≥95th percentile), and sum of triceps plus subscapular skinfold thicknesses at 3 years of age.

Results: 284 children (22.6%) were delivered by caesarean section. At age 3, 15.7% of children delivered by caesarean section were obese compared with 7.5% of children born vaginally. In multivariable logistic and linear regression models adjusting for maternal prepregnancy BMI, birth weight, and other covariates, birth by caesarean section was associated with a higher odds of obesity at age 3 (OR 2.10, 95% CI 1.36 to 3.23), higher mean BMI z-score (0.20 units, 95% CI 0.07 to 0.33), and higher sum of triceps plus subscapular skinfold thicknesses (0.94 mm, 95% CI 0.36 to 1.51).

Conclusions: Infants delivered by caesarean section may be at increased risk of childhood obesity. Further studies are needed to confirm our findings and to explore mechanisms underlying this association.

Publication types

  • Multicenter Study
  • Research Support, N.I.H., Extramural

MeSH terms

  • Birth Weight
  • Body Mass Index
  • Cesarean Section / adverse effects*
  • Child, Preschool
  • Female
  • Humans
  • Infant, Newborn
  • Massachusetts / epidemiology
  • Obesity / epidemiology
  • Obesity / etiology*
  • Overweight / epidemiology
  • Overweight / etiology
  • Pregnancy
  • Prospective Studies
  • Risk Factors
  • Skinfold Thickness
  • Socioeconomic Factors