Cesarean Birth Appears Associated with Higher Risk of Obesity in Children

Children born by cesarean delivery appear to be at a higher risk of becoming obese, especially within families when compared to their siblings born via vaginal birth, according to an article published online by JAMA Pediatrics.
 
Nearly 1.3 million cesarean deliveries are done annually in the United States. Still, the procedure carries risks for the mother and the baby.
 
Jorge E. Chavarro, M.D., Sc.D., of the Harvard T.H. Chan School of Public Health, Boston, and coauthors looked at the association between cesarean birth and risk of obesity in children among participants of the Growing Up Today Study (GUTS), who were followed from childhood through early adulthood.
 
The current study included 22,068 children born to 15,271 women followed-up over the years through questionnaires.
 
Of the 22,068 children, 4,921 were born by cesarean delivery. Women who had cesarean delivery had a higher BMI before pregnancy and were more likely to have gestational diabetes, preeclampsia and pregnancy-induced high blood pressure, the study reports.
 
Compared with vaginal birth, cesarean delivery was associated with a 15 percent increase in the risk of obesity in children after adjusting for mitigating factors, according to the results. Within families, children born by cesarean were 64 percent more likely to be obese than their siblings born by vaginal delivery.
 
Children born by vaginal birth to women who had had a previous cesarean delivery were 31 percent less likely to be obese compared with those children born to women with repeated cesarean deliveries, the study also shows.
 
Study limitations include a lack of data on indications for cesarean delivery or other detailed data on aspects of labor and delivery. The authors also lacked information on offspring microbiota or other potential biological factors to explore the underlying mechanisms. The study suggests a higher risk of obesity for children associated with cesarean birth may be related to differences in the gastrointestinal microbiota established at birth. Babies born vaginally have greater exposure to their mother’s vaginal and gastrointestinal microbiota.
 
“These findings suggest that this association may be a true adverse outcome of cesarean delivery that clinicians and patients should weigh when considering cesarean birth in the absence of a clear medical or obstetric indication,” the authors report.
 
(JAMA Pediatr. Published online September 6, 2016. doi:10.1001/jamapediatrics.2016.2385.