Caesarean delivery linked to increased risk of obesity, type 2 diabetes in adulthood

  • Chavarro JE & al.
  • JAMA Netw Open
  • 1 Apr 2020

  • curated by Sarfaroj Khan
  • UK Clinical Digest
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Takeaway

  • Women born by caesarean delivery were more likely to be obese and had a higher risk of developing type 2 diabetes (T2D) during adult life compared with those born by vaginal delivery.

Why this matters

  • Findings suggest that previously identified association between caesarean delivery and childhood obesity may extend into adulthood.

Study design

  • This prospective cohort study included 33,226 women who participated in the Nurses’ Health Study II and were born between 1946 and 1964, with follow-up through the end of the 2013-2015 follow-up cycle.
  • Main outcomes: risk of obesity and incidence of T2D.
  • Funding: The National Institutes of Health.

Key results

  • Of 33,226 participants, 1089 (3.3%) were born by caesarean delivery.
  • During 1,913,978 person-years of follow-up, 12,156 (36.6%) women were obese and 2014 (6.1%) were diagnosed with T2D.
  • Women born by caesarean vs vaginal delivery were at a higher risk of obesity (relative risk [RR], 1.11; 95% CI, 1.03-1.19).
  • The adjusted HR for T2D in women born by caesarean vs vaginal delivery was 1.46 (95% CI, 1.18-1.81), this association persisted after further adjustment for the participant’s own body mass index (HR, 1.34; 95% CI, 1.08-1.67).
  • These associations persisted in analyses restricted to women at low risk for cesarean delivery based on maternal characteristics.

Limitations

  • Lack of data on indications for caesarean delivery.
  • Possibility of residual confounding.