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Caesarean delivery is associated with an absolute increase in the prevalence of overweight in the offspring: The SENDO project
Author(s) -
MorenoGalarraga Laura,
Romanos Nanclares Andrea,
GarcíaBlanco Lorena,
Esteve Cornejo Cristina,
Domingo Cardenal Borja,
MartínezGonzález Miguel A,
MartínCalvo Nerea
Publication year - 2021
Publication title -
journal of paediatrics and child health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.631
H-Index - 76
eISSN - 1440-1754
pISSN - 1034-4810
DOI - 10.1111/jpc.15328
Subject(s) - medicine , overweight , confounding , odds ratio , obesity , caesarean section , offspring , obstetrics , confidence interval , body mass index , caesarean delivery , relative risk , marginal structural model , demography , pregnancy , pediatrics , sociology , biology , genetics
Aim The association between caesarean delivery and the risk of overweight/obesity in the offspring has been previously reported using conventional measures of association (relative risks or odds ratios). We aimed at refining the existing evidence by calculating the marginal effect of the exposure and estimating the unmeasured residual confounding. Methods In the ‘SEguimiento del Niño para un Desarrollo Óptimo’ Project, a dynamic multipurpose paediatric cohort study, we collected information from parents through self‐administered online questionnaires. We estimated the offspring's risk of overweight/obesity at age 4–6 years, associated with the type of delivery through marginal effect of the exposure. Unmeasured residual confounding was assessed using the E ‐value. Results Among 407 participants (mean‐age: 5.0 years (standard deviation: 0.9)), 86 (21.1%) were born by caesarean delivery. Children born by caesarean delivery had higher odds of overweight/obesity than those born vaginally. Subgroup analyses showed similar results. The multivariable adjusted marginal effect showed that caesarean delivery was associated with an 8.0% (95% confidence interval: 0.2–15.7) absolute increase in the prevalence of overweight/obesity. The estimated residual confounding showed an E‐value of 4.03, higher than the OR obtained for all the confounding factors we accounted for. Conclusions Caesarean delivery was associated with an 8% absolute increase in the risk of overweight/obesity that is very unlikely explained by residual confounding.