Caesarean section delivery and childhood obesity in a British longitudinal cohort study.

Masukume, G; Khashan, AS; Morton, SMB; Baker, PN; Kenny, LC; McCarthy, FP

Caesarean section delivery and childhood obesity in a British longitudinal cohort study.

Masukume, G Khashan, AS Morton, SMB Baker, PN Kenny, LC McCarthy, FP

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Publisher:: PUBLIC LIBRARY SCIENCE
Publication Type:: Journal Article
Citation:: PLoS One, 2019, 14, (10), pp. e0223856
Issue Date:: 2019

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Field	Value	Language
dc.contributor.author	Masukume, G
dc.contributor.author	Khashan, AS
dc.contributor.author	Morton, SMB
dc.contributor.author	Baker, PN
dc.contributor.author	Kenny, LC
dc.contributor.author	McCarthy, FP
dc.contributor.editor	Simeoni, U
dc.date.accessioned	2025-01-13T02:55:42Z
dc.date.available	2019-09-29
dc.date.available	2025-01-13T02:55:42Z
dc.date.issued	2019
dc.identifier.citation	PLoS One, 2019, 14, (10), pp. e0223856
dc.identifier.issn	1932-6203
dc.identifier.issn	1932-6203
dc.identifier.uri	http://hdl.handle.net/10453/183321
dc.description.abstract	BACKGROUND: Several studies reported an association between Caesarean section (CS) birth and childhood obesity. However, there are several limitations in the current literature. These include an inability to distinguish between planned and emergency CS, small study sample sizes and not adjusting for pre-pregnancy body-mass-index (BMI). We examined the association between CS delivery and childhood obesity using the United Kingdom Millennium Cohort Study (MCS). METHODS: Mother-infant pairs were recruited into the MCS. Use of sampling weights ensured the sample was representative of the population. The exposure was categorised as normal vaginal delivery (VD) [reference], assisted VD, planned CS and emergency CS. Childhood obesity prevalence, at age three, five, seven, eleven and fourteen years was calculated using the International Obesity Taskforce criteria. Mixed-effects linear regression models were fitted with associations adjusted for several potential confounders like maternal age, pre-pregnancy BMI, education and infant macrosomia. Linear regression models were fitted evaluating body fat percentage (BF%), at age seven and fourteen years. RESULTS: Of the 18,116 infants, 3872 (21.4%) were delivered by CS; 9.2% by planned CS. Obesity prevalence was 5.4%, 5.7%, 6.5%, 7.1% and 7.6% at age three, five, seven, eleven and fourteen years respectively. The mixed-effects linear regression model showed no association between planned (adjusted mean difference = 0.00; [95% confidence interval (CI) -0.10; 0.10], p-value = 0.97) or emergency CS (adjusted mean difference = 0.08; [95% CI -0.01; 0.17], p-value = 0.09) and child BMI. At age seven years, there was no association between planned CS and BF% (adjusted mean difference = 0.13; [95% CI -0.23; 0.49]); there was no association at age fourteen years. CONCLUSIONS: Infants born by planned CS did not have a significantly higher BMI or BF% compared to those born by normal VD. This may suggest that the association, described in the literature, could be due to the indications/reasons for CS birth or residual confounding.
dc.format	Electronic-eCollection
dc.language	eng
dc.publisher	PUBLIC LIBRARY SCIENCE
dc.relation.ispartof	PLoS One
dc.relation.isbasedon	10.1371/journal.pone.0223856
dc.rights	info:eu-repo/semantics/openAccess
dc.subject.classification	General Science & Technology
dc.subject.mesh	Adipose Tissue
dc.subject.mesh	Adult
dc.subject.mesh	Cesarean Section
dc.subject.mesh	Child
dc.subject.mesh	Cohort Studies
dc.subject.mesh	Female
dc.subject.mesh	Humans
dc.subject.mesh	Infant
dc.subject.mesh	Longitudinal Studies
dc.subject.mesh	Male
dc.subject.mesh	Pediatric Obesity
dc.subject.mesh	Risk Factors
dc.subject.mesh	United Kingdom
dc.subject.mesh	Young Adult
dc.subject.mesh	Adipose Tissue
dc.subject.mesh	Humans
dc.subject.mesh	Cesarean Section
dc.subject.mesh	Risk Factors
dc.subject.mesh	Cohort Studies
dc.subject.mesh	Longitudinal Studies
dc.subject.mesh	Adult
dc.subject.mesh	Child
dc.subject.mesh	Infant
dc.subject.mesh	Female
dc.subject.mesh	Male
dc.subject.mesh	Young Adult
dc.subject.mesh	Pediatric Obesity
dc.subject.mesh	United Kingdom
dc.subject.mesh	Adipose Tissue
dc.subject.mesh	Adult
dc.subject.mesh	Cesarean Section
dc.subject.mesh	Child
dc.subject.mesh	Cohort Studies
dc.subject.mesh	Female
dc.subject.mesh	Humans
dc.subject.mesh	Infant
dc.subject.mesh	Longitudinal Studies
dc.subject.mesh	Male
dc.subject.mesh	Pediatric Obesity
dc.subject.mesh	Risk Factors
dc.subject.mesh	United Kingdom
dc.subject.mesh	Young Adult
dc.title	Caesarean section delivery and childhood obesity in a British longitudinal cohort study.
dc.type	Journal Article
utslib.citation.volume	14
utslib.location.activity	United States
pubs.organisational-group	University of Technology Sydney
pubs.organisational-group	University of Technology Sydney/Faculty of Health
pubs.organisational-group	University of Technology Sydney/UTS Groups
pubs.organisational-group	University of Technology Sydney/UTS Groups/Women & Children’s Health Research Collaborative (WCHC)
pubs.organisational-group	University of Technology Sydney/UTS Groups/INSIGHT: Institute for Innovative Solutions for Well-being and Health
utslib.copyright.status	open_access	*
dc.rights.license	This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0). To view a copy of this license, visit https://creativecommons.org/licenses/by/4.0/
dc.date.updated	2025-01-13T02:55:40Z
pubs.issue	10
pubs.publication-status	Published online
pubs.volume	14
utslib.citation.issue	10

Abstract:

BACKGROUND: Several studies reported an association between Caesarean section (CS) birth and childhood obesity. However, there are several limitations in the current literature. These include an inability to distinguish between planned and emergency CS, small study sample sizes and not adjusting for pre-pregnancy body-mass-index (BMI). We examined the association between CS delivery and childhood obesity using the United Kingdom Millennium Cohort Study (MCS). METHODS: Mother-infant pairs were recruited into the MCS. Use of sampling weights ensured the sample was representative of the population. The exposure was categorised as normal vaginal delivery (VD) [reference], assisted VD, planned CS and emergency CS. Childhood obesity prevalence, at age three, five, seven, eleven and fourteen years was calculated using the International Obesity Taskforce criteria. Mixed-effects linear regression models were fitted with associations adjusted for several potential confounders like maternal age, pre-pregnancy BMI, education and infant macrosomia. Linear regression models were fitted evaluating body fat percentage (BF%), at age seven and fourteen years. RESULTS: Of the 18,116 infants, 3872 (21.4%) were delivered by CS; 9.2% by planned CS. Obesity prevalence was 5.4%, 5.7%, 6.5%, 7.1% and 7.6% at age three, five, seven, eleven and fourteen years respectively. The mixed-effects linear regression model showed no association between planned (adjusted mean difference = 0.00; [95% confidence interval (CI) -0.10; 0.10], p-value = 0.97) or emergency CS (adjusted mean difference = 0.08; [95% CI -0.01; 0.17], p-value = 0.09) and child BMI. At age seven years, there was no association between planned CS and BF% (adjusted mean difference = 0.13; [95% CI -0.23; 0.49]); there was no association at age fourteen years. CONCLUSIONS: Infants born by planned CS did not have a significantly higher BMI or BF% compared to those born by normal VD. This may suggest that the association, described in the literature, could be due to the indications/reasons for CS birth or residual confounding.

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