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Cesarean Delivery and the Long-Term Risk of Offspring Obesity

Mamun, Abdullah A PhD; Sutharsan, Ratneswary PhD; O’Callaghan, Michael MBBS, MSc; Williams, Gail PhD; Najman, Jake PhD; McIntyre, Harold David PhD; Callaway, Leonie PhD

doi: 10.1097/AOG.0000000000000016
Contents: Cesarean Delivery: Original Research

OBJECTIVE: To examine the association between the mode of delivery and the risk of offspring obesity by age 21 years using a large community-based birth cohort study in Australia.

METHODS: We followed-up a subsample of 2,625 offspring for whom we had measured physical assessments, including height and weight at 21 years and hospital-recorded mode of delivery, in the Mater Hospital in Brisbane, Australia, between 1981 and 1983. Body mass index (BMI) and waist circumference were measured at 21 years. Multivariable regression analysis was used to examine the independent associations of mode of delivery with offspring BMI and waist circumference.

RESULTS: In the cohort, 12.1% were born by cesarean delivery. Maternal and birth factors independently associated with the mode of delivery were age, overweight and obesity status, smoking status during pregnancy, hypertensive disorder during pregnancy, and neonatal low birth weight. By 21 years, 21.5% of offspring were overweight and 12.4% were obese. Offspring overweight and obesity status, as well as BMI and waist circumference, were not associated with the mode of delivery.

CONCLUSIONS: Findings of this study do not support the idea that cesarean delivery has increased the risk of long-term offspring obesity.

LEVEL OF EVIDENCE: III

Cesarean delivery is not associated with a risk of long-term offspring obesity.

Schools of Population Health and Medicine, University of Queensland, Eskitis Institute, Griffith University, Mater Children's Hospital, Mater Health Services, and Royal Brisbane and Women's Hospital, Brisbane, Australia.

Corresponding author: Abdullah Al Mamun, PhD, Associate Professor, School of Population Health, The University of Queensland, Herston Rd, Herston, QLD 4006, Australia; e-mail: mamun@sph.uq.edu.au.

The core study was funded by the National Health and Medical Research Council (NHMRC ID 631507) of Australia. A.A.M. is supported by a Career Development Awards from the NHMRC (ID 1026598). For the work in this article, A.A.M. received a grant from the National Heart Foundation of Australia (ID G07B3135). The views expressed in the article are those of the authors and not necessarily those of any funding body, and no funding body influenced the way in which the data were analyzed and presented.

The authors thank all participants in the study, the Mater University of Queensland Study of Pregnancy data collection and management team, and the University of Queensland who helped to store and manage the data for the Mater University of Queensland Study of Pregnancy.

Financial Disclosure The authors did not report any potential conflicts of interest.

© 2013 by The American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved.