C-Section May Hike Risk for Toddlers’ Obesity, Study Suggests

WEDNESDAY, May 23 (HealthDay News) — Babies born by Caesarean
section are twice as likely to be obese by age 3 as infants delivered
vaginally, a new study suggests.

In the United States today, about one in three babies is born via
C-section, and one in three kids is overweight or obese.

“Women who may be considering a C-section in the absence of a medical
indication should be counseled that their children may have a higher risk
of obesity,” said study author Dr. Susanna Huh, director of the growth and
nutrition program at Children’s Hospital in Boston.

The study included more than 1,250 mother-child pairs admitted to
Massachusetts hospitals between 1999 and 2002. All of the mothers joined
the study before 22 weeks into their pregnancy, and 25 percent of babies
were delivered by C-section. The rest were delivered vaginally.

Babies were measured and weighed at birth, at 6 months and again at age
3.

Average birth weight was not statistically higher for babies born by
C-section. But nearly 16 percent of children delivered via C-section were
obese by the age of 3, compared with 7.5 percent of those born vaginally.
Also, about 19 percent of the C-section kids were overweight compared to
just less than 17 percent of the others.

Those children delivered by C-section also had higher skinfold
thickness (a measure of body fat) at age 3, the study showed.

The researchers said their findings held even after they compensated
for factors known to increase the risk of childhood obesity, including
overweight mothers and high birth weight.

Exactly what is driving the increased risk for obesity is not fully
understood.

“We speculate that the different modes of delivery may influence the
bacteria in the gut at birth, and it is possible that gut bacteria may
influence obesity by affecting the calories and nutrients absorbed from
diet,” Huh said. The bacteria also may stimulate cells in a way that
boosts insulin resistance, inflammation and fat, the authors noted.

Another possibility is that some of the hormones released during labor
may influence obesity development.

“Further research is needed to confirm our findings, as well as to
explore the underlying mechanism for this association,” Huh said.

The study does not prove that C-sections cause obesity, however, and
fear that a child could become overweight should not scare women who need
a surgical delivery, one expert said.

There are many valid medical reasons for C-section delivery, said Dr.
Amos Grunebaum, an associate attending obstetrician and gynecologist at
New York-Presbyterian Hospital/Weill Cornell Medical Center in New York
City. These include babies in breach position (buttocks and feet first),
babies in distress and labors that don’t progress.

“When you have an indication for a C-section, the risk of not doing it
is so high,” Grunebaum said. “Having a baby with a potential future risk
of obesity is not a good enough reason to not do one.”

The report is scheduled for publication online May 24 in the journal
Archives of Disease in Childhood.

Between 4 percent and 18 percent of C-sections in the United States are
performed at the mother’s request, the researchers noted.

Dr. Mitchell Maiman, chairman of obstetrics and gynecology at Staten
Island University Hospital in New York City, is quick to point out the
dangers associated with C-section delivery when it is done without a clear
medical indication.

“The risks to the mother are enormous, if not with the first, then with
the repeat surgeries,” he said. “The risk of catastrophic complications
from repeat surgery is really, really serious.”

Maiman said the rising C-section rates in the United States are not
justifiable. “Many women who have had a C-section can safely deliver
vaginally in the future,” he noted. “This is known as vaginal birth after
Caesarean.”

“Babies delivered via C-section have more pulmonary problems [and] are
more likely to wind up in the intensive-care unit, and now there is the
possibility that obesity rates will be twice as high,” he said.

Caesarean birth also is known to raise the risk of childhood asthma and
allergies, the study authors added.

More information

Learn more about vaginal birth after Caesarean at the
American College of Obstetricians and Gynecologists.

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