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Cited by 301Maternal and Perinatal Health InterventionsObesity, Physical Activity, DietBirth, Development, and Health

The impact of cesarean section on offspring overweight and obesity: a systematic review and meta-analysis

Li, H-t, Zhou, Y-b, Liu, J-m·2013·International Journal of Obesity
DOI 10.1038/ijo.2012.195
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Abstract

Studies have reported inconsistent results concerning the association of cesarean section with offspring obesity. We performed a systematic review and meta-analysis to examine whether cesarean section increases the risk of later overweight and obesity. Pubmed, Embase and Web of Science were searched using different combinations of two groups of keywords: 'cesarean' and 'overweight/obesity'. Cohort or case-control studies that reported the association of cesarean section with childhood (3-8 years), adolescence (9-18 years) and/or adult (>19 years) overweight/obesity were eligible. Where possible, adjusted risk estimates were pooled using a random effects model; otherwise unadjusted estimates were pooled. Statistical heterogeneity was assessed with I(2) statistics; the values of 25%, 50% and 75% were considered to indicate low, medium and high heterogeneity, respectively. We conducted a subgroup analysis to identify the sources of heterogeneity according to study quality defined on the basis of the Newcastle-Ottawa Scale. In total, two case-control and seven cohort studies were identified for the literature review and 15 separate risk estimates were included in the meta-analysis. The overall pooled odds ratio (OR) of overweight/obesity for offspring delivered by cesarean section compared with those born vaginally was 1.33 (95% confidence interval (CI) 1.19, 1.48; I(2)=63%); the OR was 1.32 (1.15, 1.51) for children, 1.24 (1.00, 1.54) for adolescents and 1.50 (1.02, 2.20) for adults. In subgroup analysis, the overall pooled OR was 1.18 (1.09, 1.27; I(2)=29%) for high-quality studies and 1.78 (1.43, 2.22; I(2)=24%) for medium-quality (P for interaction=0.0005); no low-quality studies were identified. The ORs for children, adolescents and adults all tended to be lower for high-quality studies compared with medium-quality studies. Our results indicated that cesarean section was moderately associated with offspring overweight and obesity. This finding has public health implications, given the increase in cesarean births in many countries.

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  • Cesarean birth is associated with adverse child health outcomes including asthma, type I diabetes, allergies, and obesity.

    “established links between cesarean birth and adverse child health outcomes, including asthma, type I diabetes, allergies9–11 and obesity12”

    From The relation between cesarean birth and child cognitive development (2017) · cites this paper as [12]

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Authors
Li, H.-T., Zhou, Y.-B., & Liu, J.-M.
Affiliations
Peking University (CN)
Corresponding author
Liu, J-m
Venue
International Journal of Obesity
Publisher
Springer Science and Business Media LLC
Published
2012-12-04
Volume
37
Issue
7
Pages
893-899
ISSN
  • 0307-0565 (ISSN-L)
  • 1476-5497
DOI
10.1038/ijo.2012.195
OpenAlex
W2013863661
Cited by
301
References
36
Citations by year
2026: 7 · 2025: 10 · 2024: 23 · 2023: 26 · 2022: 30 · 2021: 28 · 2020: 25 · 2019: 30 · 2018: 29 · 2017: 28 · 2016: 24 · 2015: 14 · 2014: 17 · 2013: 9
FWCI
2.09
Type
journal article
Language
en
Open access
closed
Licence
www.springer.com/tdm (tdm)
Locations
  • International Journal of Obesity (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Obstetrics and Gynecology › Maternal and Perinatal Health Interventions
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Birth, Development, and Health
Keywords
cesarean section, childhood obesity, adolescent obesity, adult obesity, overweight, mode of delivery, vaginal delivery, study quality, quality heterogeneity
MeSH terms
Adolescent, Cesarean Section, Child, Child, Preschool, China, Disease Susceptibility, Female, Humans, Male, Pregnancy, Public Health, Risk Factors, Body Mass Index, Odds Ratio, Overweight, Pediatric Obesity

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