Cesarean section may increase the risk of both overweight and obesity in preschool children.
The increase rates of cesarean section (CS) occurred at the same period as the dramatic increase of childhood overweight/obesity. In China, cesarean section rates have exponentially increased in the last 20 years and they now exceed World Health Organization (WHO) recommendation. Such high rates demand an understanding to the long-term consequences on child health. We aim to examine the association between CS and risk of overweight and obesity among preschool children.



We recruited 9103 children from 35 kindergartens in 4 cities located in East China. Children anthropometric measurements were taken in person by trained personnel. The mode of delivery was classified as vaginal or CS, in sub-analyses we divided cesarean delivery into elective or non-elective. The mode of delivery and other parental information were self-reported by parents. Multivariate logistic regression analysis was used to examine the associations.



In our cross-sectional study of 8900 preschool children aged 3-6 years, 67.3 % were born via CS, of whom 15.7 % were obese. Cesarean delivery was significantly associated with the risk of overweight [OR 1.24; (95 % CI 1.07-1.44); p = 0.003], and the risk of obesity [OR 1.29; (95 % CI 1.13-1.49); p < 0.001] in preschool children. After adjusted for child characteristics, parental factors and family income, the odd of overweight was 1.35 and of obesity was 1.25 in children delivered by elective CS.



The associations between CS and overweight/obesity in preschool children are influenced by potential confounders. Both children delivered by elective or non-elective CS are at increased risk of overweight/obesity. Potential consequences of CS on the health of the children should be discussed among both health care professionals and childbearing women.
Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui Province, 230032, China.
Erigene
E
Rutayisire
Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui Province, 230032, China.|Anhui Provincial Key Laboratory of Population Health & Aristogenics, Hefei, 230032, China.
Xiaoyan
X
Wu
Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui Province, 230032, China.|Anhui Provincial Key Laboratory of Population Health & Aristogenics, Hefei, 230032, China.
Kun
K
Huang
Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui Province, 230032, China.
Shuman
S
Tao
Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui Province, 230032, China.
Yunxiao
Y
Chen
Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui Province, 230032, China. taofangbiao@126.com.|Anhui Provincial Key Laboratory of Population Health & Aristogenics, Hefei, 230032, China. taofangbiao@126.com.
Fangbiao
F
Tao
D002585:Cesarean Section / Q000009:adverse effects*; D002648:Child; D002675:Child, Preschool; D002681:China; D003430:Cross-Sectional Studies; D036861:Delivery, Obstetric / Q000009:adverse effects / Q000379:methods; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D050177:Overweight / Q000209:etiology*; D063766:Pediatric Obesity / Q000209:etiology*; D011247:Pregnancy; D012307:Risk Factors
Elective cesarean section; Non-elective cesarean section; Obesity; Oveweight; Preschool children