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Grand Rounds

Is There a Link Between Cesarean Delivery and Obesity in Young Adulthood?

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BACKGROUND AND PURPOSE:

  • Ahlqvist et al. (PLoS Medicine, 2019) investigated the possible association between cesarean section and risk of obesity in young adulthood

METHODS:

  • Retrospective cohort study
  • Participants
    • Swedish males born between 1982 and 1987
  • Data sources
    • Swedish population registers
    • Medical Birth Register
  • Study design
    • 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
  • Data analysis
    • 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

RESULTS:

  • 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)

CONCLUSION:

  • 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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Learn More – Primary Sources:

Elective and nonelective cesarean section and obesity among young adult male offspring: A Swedish population–based cohort study

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Related ObG Topics:

Is Cesarean Section Associated with Increased BMI in Offspring?
Does Gestational Hypertension Increase Risk of Type 2 Diabetes in Adult Offspring?
Maternal Overweight, Obesity and Congenital Malformations – How Strong is the Link?

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