Association Between Cesarean Birth and Risk of Obesity in Offspring in Childhood, Adolescence, and Early Adulthood

Abstract

Nearly 1.3 million cesarean deliveries are performed yearly in the United States, making it the most common surgical procedure¹ and accounting for one-third of deliveries nationwide.² When indicated, cesarean deliveries reduce the risk of morbidity to mother and fetus and, in many cases, are a life-saving intervention.³ Nevertheless, cesarean deliveries have risks. Women undergoing planned cesarean delivery without known indications for the procedure have a 3-fold greater risk of major morbidity—including a 5-fold greater risk of cardiac arrest, a 3-fold greater risk of hysterectomy and puerperal infection, and a 2-fold greater risk of thromboembolism—compared with women who undergo low-risk planned vaginal deliveries.⁴ Cesarean delivery is also associated with an increased risk of maternal mortality.⁵ The most significant immediate risk to children delivered via cesarean delivery is a higher frequency of respiratory complications.^6,7 In addition, increasing evidence suggests that children born by cesarean delivery experience higher rates of adverse health outcomes later in life.^8-10 With these concerns in mind, leading professional organizations have advocated for the prevention of primary cesarean delivery as a strategy to reduce the overall frequency of cesarean delivery.¹¹