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Published on: February 2, 2017
Effect of Elective Cesarean Section on Children's Obesity From Birth to Adolescence: A Systematic Review and
Shanshan Zhang1,2,3,4, Xiaoyun Qin1,2,3,4, Peixuan Li1,2,3,4
1Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China.
Insights
Children born via elective cesarean section (ECS) face a higher risk of obesity. This systematic review highlights the link between ECS and increased childhood obesity rates, informing early intervention strategies.
Area of Science:
- Pediatrics
- Public Health
- Epidemiology
Background:
- Elective cesarean section (ECS) is a leading cause of rising cesarean rates globally, with potential adverse outcomes for mothers and infants.
- Previous research on the association between ECS and childhood overweight/obesity has yielded conflicting results.
- This study addresses the controversy by systematically reviewing the evidence on ECS and offspring overweight/obesity.
Approach:
- A comprehensive systematic review and meta-analysis was conducted.
- Searches were performed across multiple databases including PubMed, Science Direct, Web of Science, CNKI, Wanfang, and China Biology Medicine disc.
- Nine cohort studies with 11 independent risk estimates were identified and analyzed.
Key Points:
- A significant association was found between ECS and childhood obesity (pooled RR = 1.10, 95% CI: 1.01-1.18).
- Subgroup analysis indicated ECS is linked to obesity in preschoolers (RR = 1.12, 95% CI: 1.02-1.22).
- The association was more pronounced in regions with ECS rates exceeding 10%; no significant link to overweight was observed.
Conclusions:
- Children delivered via ECS demonstrate an elevated risk of developing obesity later in life.
- These findings offer crucial evidence for developing early-life interventions to combat the global rise in childhood obesity.
- The study underscores the importance of considering delivery mode in pediatric health outcomes.
Background:
Elective cesarean section (ECS) is the most common reason for the increasing cesarean section rate worldwide, and it is reported to be related to adverse short-term and long-term outcomes in both mothers and infants. Findings on the association between ECS and overweight and obesity in children are controversial in recent studies. Therefore, we conducted a systematic review and meta-analysis to examine the effect of ECS on offspring's overweight and obesity.
Methods:
PubMed, Science Direct, Web of Science, CNKI (China National Knowledge Infrastructure), Wanfang Database (in Chinese), and China Biology Medicine disc databases were searched using different combinations of three groups of keywords: "elective cesarean section," "overweight/obesity," and "children." Nine cohort studies and 11 independent risk estimates were finally identified.
Results:
We have observed significant association between ECS and children's obesity, the total pooled risk ratio (RR) being 1.10 (95% CI: 1.01-1.18; I 2 = 32.4%). In subgroup analysis, ECS was found to be associated with the occurrence of obesity in preschoolers (RR = 1.12, 95% CI: 1.02-1.22; I 2 = 16.8%). Furthermore, it revealed that ECS was related with the high risk of children's obesity where the rate of ECS exceeded 10%. No significant association was observed between ECS and children's overweight, and the RR was 1.12 (95% CI: 0.94-1.30; I 2 = 55.6%).
Conclusions:
Overall, it indicated that children born via ECS had an increased risk of later-life obesity. Given the global increase in childhood obesity, our findings would provide evidence-based reference for early life intervention on children's obesity.
Systematic Review Registration:
https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021267211, identifier: CRD42021267211.
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