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Title: The Impact of Caesarean Section on the Risk of Childhood Overweight and Obesity: New Evidence from a Contemporary Cohort Study.
Authors: Masukume, Gwinyai
O'Neill, Sinéad M.
Baker, Philip N.
Kenny, Louise C.
Morton, Susan M. B.
Khashan, Ali S.
First Published: 11-Oct-2018
Publisher: Nature Research (part of Springer Nature)
Citation: Scientific Reports, 2018, volume 8, Article number: 15113
Abstract: Caesarean section (CS) rates are increasing globally and exceed 50% in some countries. Childhood obesity has been linked to CS via lack of exposure to vaginal microflora although the literature is inconsistent. We investigated the association between CS birth and the risk of childhood obesity using the nationally representative Growing-Up-in-Ireland (GUI) cohort. The GUI study recruited randomly 11134 infants. The exposure was categorised into normal vaginal birth (VD) [reference], assisted VD, elective (planned) CS and emergency (unplanned) CS. The primary outcome measure was obesity defined according to the International Obesity Taskforce criteria. Statistical analysis included multinomial logistic regression with adjustment for potential confounders. Infants delivered by elective CS had an adjusted relative risk ratio (aRRR) = 1.32; [95% confidence interval (CI) 1.01-1.74] of being obese at age three years. This association was attenuated when macrosomic children were excluded (aRRR = 0.99; [95% CI 0.67-1.45]). Infants delivered by emergency CS had an increased risk of obesity aRRR = 1.56; [95% CI 1.20-2.03]; this association remained after excluding macrosomic children. We found insufficient evidence to support a causal relationship between elective CS and childhood obesity. An increased risk of obesity in children born by emergency CS, but not elective, suggests that there is no causal effect due to vaginal microflora.
DOI Link: 10.1038/s41598-018-33482-z
eISSN: 2045-2322
Version: Publisher Version
Status: Peer-reviewed
Type: Journal Article
Rights: Copyright © the authors, 2018. This is an open-access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Description: The data that support the findings of this study are available from the Irish Social Science Data Archive (ISSDA),, but restrictions apply to the availability of these data, which were used under license for the current study, and so are not publicly available. Bona fide researchers can apply for the data from ISSDA. Supplementary information accompanies this paper at
Appears in Collections:Published Articles, College of Medicine, Biological Sciences and Psychology

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