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ToolsMasukume, Gwinyai, Khashan, Ali S., Morton, Susan M. B., Baker, Philip N., Kenny, Louise C. and McCarthy, Fergus P. (2019) Caesarean section delivery and childhood obesity in a British longitudinal cohort study. PLoS One, 14 (10). ISSN 1932-6203
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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 betweenplanned 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.
| Item Type: | Article |
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| Additional Information: | © 2019 Masukume et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Data Availability: The authors collected data from the United Kingdom Data Service https://www.ukdataservice.ac.uk/. The Millennium Cohort Study data is available free of charge to interested researchers. Authors confirm that these datasets can be accessed by others in the same manner as the authors and they did not have special access privileges. Funding: G.M. is supported by the Irish Centre for Fetal and Neonatal Translational Research (INFANT) (grant no. 12/RC/2272). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. |
| Uncontrolled Keywords: | general,sdg 3 - good health and well-being ,/dk/atira/pure/subjectarea/asjc/1000 |
| Faculty \ School: | Faculty of Medicine and Health Sciences > Norwich Medical School |
| Related URLs: | |
| Depositing User: | LivePure Connector |
| Date Deposited: | 23 Jun 2025 16:30 |
| Last Modified: | 23 Jun 2025 16:30 |
| URI: | https://ueaeprints.uea.ac.uk/id/eprint/99676 |
| DOI: | 10.1371/journal.pone.0223856 |
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