Is There a Link Between Cesarean Delivery and Obesity in Young Adulthood?
BACKGROUND AND PURPOSE:
Ahlqvist et al. (PLoS Medicine, 2019) investigated the possible association between cesarean section and risk of obesity in young adulthood
Retrospective cohort study
Swedish males born between 1982 and 1987
Swedish population registers
Medical Birth Register
Participants were followed from birth until conscription (median 18 years of age) if they conscripted before 2006
At conscription: Weight and height were measured and transformed to WHO categories based on BMI
Associations were evaluated using linear regression
Adjustments made for potential confounders, including
Prepregnancy maternal BMI | Maternal diabetes at delivery | Maternal hypertension at delivery | Maternal smoking | Parity | Parental education | Maternal age at delivery | Gestational age | Birth weight standardized according to gestational age | Preeclampsia
97,291 men were included
Average maternal age at delivery: 28.5 years
Average prepregnancy BMI: 21.9
41.5% of the conscripts had at least one parent with university-level education
Obesity (BMI ≥ 30) of conscripts: 4.9%
Slight difference in prevalence of obesity based on mode of delivery
Vaginal delivery: 4.9%
Elective cesarean: 5.5%
Nonelective cesarean: 5.6%
After accounting for potential confounders, when compared with vaginal delivery, there was no evidence of an association between nonelective or elective CS and young adulthood obesity
Nonelective cesarean (p = 0.532)
Relative risk ratio 0.96 (95% CI, 0.83 to 1.10)
Elective cesarean (p = 0.826)
Relative risk ratio 1.02 (95% CI, 0.88 to 1.18)
Likewise, compared with vaginal delivery, there was no evidence for an association between any form of CS and overweight (BMI ≥ 25)
This study did not find evidence of a link between overweight or obesity based on mode of delivery in young adulthood
The authors point out that one limitation of their study was that the cohort only included a male population
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