Does cesarean delivery lead to high risk of childhood obesity?

Emobileclinic Researchers Corner 

Researchers from the Harvard T. H C Chan School of Public Health in Boston have postulated that the mode of delivery of a child has significant effect on the development of obesity in later life. The team in their study found that children delivered through cesarean delivery have higher risk of becoming obese, compared with their siblings born through vaginal delivery. This fascinating finding was published by JAMA Pediatrics.

This finding is seen to have significant implications for the increasing cesarean births across the globe. Several studies have identified respiratory problems and increased risk of other adverse health conditions in children born through cesarean section.

This study sought to identify if cesarean delivery has a link with obesity in children and young adults by examining participants of the Growing Up Today Study (GUTS), a large group of individuals followed up through questionnaires from childhood through early adulthood.

The participants in the study consisted of 15271 women who gave birth to 22,068 children out of which 4,921 (representing 22.3 percent) of the births were through cesarean delivery.

The results reveal that women who had cesarean delivery recorded a higher Body Mass Index (BMI) prior to pregnancy and as such have increased risk factor to developing gestational diabetes, preeclampsia and pregnancy-induced hypertension as well as the possibility of previous cesarean delivery.

The result furthered shown that cesarean delivery was responsible for 15 percent higher risk of obesity in children when compared with those born by vaginal delivery. Also, children delivered through cesarean had 64 percent vulnerability to developing obesity when compared with their siblings born through vaginal delivery.
The team found that children born by vaginal delivery had a 31 percent reduced risk of obesity when compared with children whose mothers had multiple cesarean deliveries.

In finding out the cause of obesity, the team hypothesized that the reported higher risk of obesity may be a result of differences in gastrointestinal microbiota presented at birth. It was expected that children born through vaginal delivery would enjoy much exposure to their mother’s gastrointestinal microbiota than children delivered via cesarean section.

The authors said they “observed an association between cesarean delivery and increased risk of obesity in offspring that persisted through early adult life and added that they also reported “for the first time, to our knowledge, a protective effect of vaginal birth after cesarean delivery on obesity in offspring and a significant difference in risk of obesity between siblings whose modes of birth were discordant”.

Furthermore according to them, “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 team advocates for research from large, prospective studies with high-quality data on pre-pregnancy, pregnancy and delivery which will enable prospective researchers to examine whether increased rates of obesity account for greater risk of adverse cardiometabolic outcomes such as type 2 diabetes, high blood pressure, or cardiovascular disease among individuals delivered by cesarean delivery.

Source
Changzheng Yuan, et al. (2016): Association between cesarean birth and risk of obesity in offspring in childhood, adolescence and early adulthood. JAMA Pediatrics, doi:10.1001/jamapediatrics.2016.2385