Cesarean Delivery and Offspring Risk of Obesity and Overweight during Adolescence: A Prospective Cohort Study

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Abstract

Recent studies have indicated that cesarean section, an increasingly common method of childbirth, may increase an offspring’s obesity risk. There are few prospective studies, and even fewer utilizing an adolescent population to measure the long-term health consequences for offspring born via cesarean section. We used data from the state-wide, population-based Utah Population Database, which linked data on delivery mode from birth certificates (1990-1992) to height and weight information from driver’s licenses (2005-2009; ages 15-18 years) (n=60,206). We estimated the association of cesarean delivery with BMI (kg/m2) using ordinary least-squares regression and with overweight prevalence and obesity prevalence using logistic regression. Adjusted for maternal pre-pregnancy BMI and sociodemographic, clinical, and behavioral covariates, adolescents delivered via cesarean section had 13% higher odds of being obese (p<.01), 12% higher odds of being overweight (p<.001), and 0.15 units greater BMI. We did not find evidence that associations varied by sex or race-ethnicity. In a large, multiethnic, sample of adolescents, we confirm long-lasting associations between cesarean section delivery and offspring obesity risk. With rates of elective cesarean deliveries increasing globally, it is imperative to understand the potential long term health risks that offspring may inadvertently face as a result of increasing use of cesarean sections. Discussion regarding the theoretical reasons for this empirical association, as well as the personal and policy implications of a child’s health risk being determined prior to (or at the time of) birth will be presented.

Author

• Rebecca L. Utz, University of Utah