The Impact of Caesarean Section on the Risk of Childhood Overweight and Obesity: New Evidence from a Contemporary Cohort Study

Abstract Caesarean section (CS) rates are increasing globally and exceed 50% in some countries. Childhood obesity has been linked to CS via lack of exposure to vaginal microflora although the literature is inconsistent. We investigated the association between CS birth and the risk of childhood obesi...

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Autores principales:	Gwinyai Masukume, Sinéad M. O’Neill, Philip N. Baker, Louise C. Kenny, Susan M. B. Morton, Ali S. Khashan
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2018
Materias:	Childhood Overweight Vaginal Microflora Normal Childbirth Childhood Obesity Growing Up In Ireland (GUI) Medicine R Science Q
Acceso en línea:	https://doaj.org/article/4fc06d8a4133422e86b7192fc2c9acd1
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spelling	oai:doaj.org-article:4fc06d8a4133422e86b7192fc2c9acd12021-12-02T15:07:45ZThe Impact of Caesarean Section on the Risk of Childhood Overweight and Obesity: New Evidence from a Contemporary Cohort Study10.1038/s41598-018-33482-z2045-2322https://doaj.org/article/4fc06d8a4133422e86b7192fc2c9acd12018-10-01T00:00:00Zhttps://doi.org/10.1038/s41598-018-33482-zhttps://doaj.org/toc/2045-2322Abstract Caesarean section (CS) rates are increasing globally and exceed 50% in some countries. Childhood obesity has been linked to CS via lack of exposure to vaginal microflora although the literature is inconsistent. We investigated the association between CS birth and the risk of childhood obesity using the nationally representative Growing-Up-in-Ireland (GUI) cohort. The GUI study recruited randomly 11134 infants. The exposure was categorised into normal vaginal birth (VD) [reference], assisted VD, elective (planned) CS and emergency (unplanned) CS. The primary outcome measure was obesity defined according to the International Obesity Taskforce criteria. Statistical analysis included multinomial logistic regression with adjustment for potential confounders. Infants delivered by elective CS had an adjusted relative risk ratio (aRRR) = 1.32; [95% confidence interval (CI) 1.01–1.74] of being obese at age three years. This association was attenuated when macrosomic children were excluded (aRRR = 0.99; [95% CI 0.67–1.45]). Infants delivered by emergency CS had an increased risk of obesity aRRR = 1.56; [95% CI 1.20–2.03]; this association remained after excluding macrosomic children. We found insufficient evidence to support a causal relationship between elective CS and childhood obesity. An increased risk of obesity in children born by emergency CS, but not elective, suggests that there is no causal effect due to vaginal microflora.Gwinyai MasukumeSinéad M. O’NeillPhilip N. BakerLouise C. KennySusan M. B. MortonAli S. KhashanNature PortfolioarticleChildhood OverweightVaginal MicrofloraNormal ChildbirthChildhood ObesityGrowing Up In Ireland (GUI)MedicineRScienceQENScientific Reports, Vol 8, Iss 1, Pp 1-9 (2018)
institution	DOAJ
collection	DOAJ
language	EN
topic	Childhood Overweight Vaginal Microflora Normal Childbirth Childhood Obesity Growing Up In Ireland (GUI) Medicine R Science Q
spellingShingle	Childhood Overweight Vaginal Microflora Normal Childbirth Childhood Obesity Growing Up In Ireland (GUI) Medicine R Science Q Gwinyai Masukume Sinéad M. O’Neill Philip N. Baker Louise C. Kenny Susan M. B. Morton Ali S. Khashan The Impact of Caesarean Section on the Risk of Childhood Overweight and Obesity: New Evidence from a Contemporary Cohort Study
description	Abstract Caesarean section (CS) rates are increasing globally and exceed 50% in some countries. Childhood obesity has been linked to CS via lack of exposure to vaginal microflora although the literature is inconsistent. We investigated the association between CS birth and the risk of childhood obesity using the nationally representative Growing-Up-in-Ireland (GUI) cohort. The GUI study recruited randomly 11134 infants. The exposure was categorised into normal vaginal birth (VD) [reference], assisted VD, elective (planned) CS and emergency (unplanned) CS. The primary outcome measure was obesity defined according to the International Obesity Taskforce criteria. Statistical analysis included multinomial logistic regression with adjustment for potential confounders. Infants delivered by elective CS had an adjusted relative risk ratio (aRRR) = 1.32; [95% confidence interval (CI) 1.01–1.74] of being obese at age three years. This association was attenuated when macrosomic children were excluded (aRRR = 0.99; [95% CI 0.67–1.45]). Infants delivered by emergency CS had an increased risk of obesity aRRR = 1.56; [95% CI 1.20–2.03]; this association remained after excluding macrosomic children. We found insufficient evidence to support a causal relationship between elective CS and childhood obesity. An increased risk of obesity in children born by emergency CS, but not elective, suggests that there is no causal effect due to vaginal microflora.
format	article
author	Gwinyai Masukume Sinéad M. O’Neill Philip N. Baker Louise C. Kenny Susan M. B. Morton Ali S. Khashan
author_facet	Gwinyai Masukume Sinéad M. O’Neill Philip N. Baker Louise C. Kenny Susan M. B. Morton Ali S. Khashan
author_sort	Gwinyai Masukume
title	The Impact of Caesarean Section on the Risk of Childhood Overweight and Obesity: New Evidence from a Contemporary Cohort Study
title_short	The Impact of Caesarean Section on the Risk of Childhood Overweight and Obesity: New Evidence from a Contemporary Cohort Study
title_full	The Impact of Caesarean Section on the Risk of Childhood Overweight and Obesity: New Evidence from a Contemporary Cohort Study
title_fullStr	The Impact of Caesarean Section on the Risk of Childhood Overweight and Obesity: New Evidence from a Contemporary Cohort Study
title_full_unstemmed	The Impact of Caesarean Section on the Risk of Childhood Overweight and Obesity: New Evidence from a Contemporary Cohort Study
title_sort	impact of caesarean section on the risk of childhood overweight and obesity: new evidence from a contemporary cohort study
publisher	Nature Portfolio
publishDate	2018
url	https://doaj.org/article/4fc06d8a4133422e86b7192fc2c9acd1
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The Impact of Caesarean Section on the Risk of Childhood Overweight and Obesity: New Evidence from a Contemporary Cohort Study

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