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Delivery by caesarean section and offspring adiposity and cardio‐metabolic health at ages 6.5, 11.5 and 16 years: results from the PROBIT cohort in Belarus
Author(s) -
RifasShiman Sheryl L,
Huh Susanna Y,
Martin Richard M,
Kramer Michael,
Patel Rita,
Bogdanovich Natalia,
Vilchuck Konstanin,
Thompson Jennifer,
Oken Emily
Publication year - 2021
Publication title -
pediatric obesity
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.226
H-Index - 69
eISSN - 2047-6310
pISSN - 2047-6302
DOI - 10.1111/ijpo.12783
Subject(s) - medicine , obstetrics , caesarean section , waist , blood pressure , body mass index , pregnancy , cohort , overweight , anthropometry , obesity , vaginal delivery , confounding , cohort study , genetics , biology
Summary Background Caesarean delivery has been associated with later adiposity, perhaps via early programming or perhaps because of residual confounding by maternal or birth characteristics. Objectives Examine associations of caesarean delivery with adiposity and cardio‐metabolic biomarkers. Methods Observational analysis of 15 069 children in the PROBIT cohort in Belarus. We examined measures of child anthropometry and blood pressure at 6.5, 11.5 and 16 years and fasting blood (11.5 years). Results Caesarean‐delivered children were slightly heavier at 6.5 (mean BMI 15.8 vs. 15.6 kg/m 2 ), 11.5 (18.4 vs. 18.2) and 16 years (21.5 vs. 21.3). After adjustment for prenatal characteristics including maternal third trimester BMI, however, we observed no association of caesarean versus vaginal delivery with child BMI (β 0.05 kg/m 2 ; 95%CI: −0.03, 0.14), sum of skinfolds (0.14 mm; −0.13, 0.42), waist circumference (−0.07 cm; −0.23, 0.10), obesity (OR 0.99; 0.76, 1.29), or systolic (−0.20 mmHg; −0.70, 0.30) or diastolic (−0.17 mmHg, −0.60, 0.26) blood pressure at 6.5 years; results were similar at 11.5 and 16 years. At 11.5 years, we observed a modest association of caesarean delivery with fasting insulin (0.33 mU/L; 0.00, 0.65). Conclusions Caesarean delivery had little or no association with adiposity or related cardio‐metabolic biomarkers in childhood. Adjustment for maternal BMI attenuated all outcome effect estimates.