ArticleJAMA pediatrics2016
Association Between Cesarean Birth and Risk of Obesity in Offspring in Childhood, Adolescence, and Early Adulthood.
Article in JAMA pediatrics, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 113 papers, 10 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
113 citing papers in PubMed, 10 syntheses or guidelines pooled it, 204 citations in OpenAlex.
- Risk Factors in the First 1000 Days of Life Associated With Childhood Obesity: A Systematic Review and Risk Factor Quality Assessment.Obesity reviews : an official journal of the International Association for the Study of Obesity · 2026Pooled it
- Cesarean delivery and blood DNA methylation at birth and childhood: Meta-analysis in the Pregnancy and Childhood Epigenetics Consortium.Science advances · 2024Pooled it
- Association of caesarean delivery with offspring health outcomes in full-cohort versus sibling-comparison studies: a comparative meta-analysis and simulation study.BMC medicine · 2023Pooled it
- Caesarean section and obesity in young adult offspring: Update of a systematic review with meta-analysis.Obesity reviews : an official journal of the International Association for the Study of Obesity · 2022Pooled it
- Effect of Elective Cesarean Section on Children's Obesity From Birth to Adolescence: A Systematic Review and Meta-Analysis.Frontiers in pediatrics · 2021Pooled it
- Change in modifiable maternal characteristics and behaviours between consecutive pregnancies and offspring adiposity: A systematic review.Obesity reviews : an official journal of the International Association for the Study of Obesity · 2020Pooled it
- Pediatrics Consequences of Caesarean Section-A Systematic Review and Meta-Analysis.International journal of environmental research and public health · 2020Pooled it
- Impact of maternal reproductive factors on cancer risks of offspring: A systematic review and meta-analysis of cohort studies.PloS one · 2020Pooled it
- The role of gut micorbiome in obesity and diabetes.World journal of pediatrics : WJP · 2019Pooled it
- Long-term risks and benefits associated with cesarean delivery for mother, baby, and subsequent pregnancies: Systematic review and meta-analysis.PLoS medicine · 2018Pooled it
- Trial
- Associations between maternal obesity and offspring gut microbiome in the first year of life.Pediatric obesity · 2022Trial
- Cesarean delivery on maternal request and common child health outcomes: A prospective cohort study in China.Journal of global health · 2022Trial
- Trial
- Trial
- Effect of Perinatal and Maternal Factors on Blood Pressure and Adiposity at Age 3.Journal of clinical hypertension (Greenwich, Conn.) · 2026Observational
- Intrapartum caesarean delivery and childhood BMI trajectories in relation to the infant gut microbiome in the VDAART prospective birth cohort.EBioMedicine · 2026Article
- The perinatal microbiota in dogs and cats: a narrative review from human research to veterinary practice.Frontiers in veterinary science · 2026Review
- Contribution of clinical factors and gut microbiota composition to weight loss in a pre-post dietary intervention pilot study in male children with obesity.Journal of endocrinological investigation · 2025Article
- Development of the preterm infant gut and gastric residuals microbiome.Nature communications · 2025Article
53 more citing papers are in PubMed but not listed here.
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Authors and funding
8 authors at 5 institutions in 1 country.
Funding
Abstract
Importance: Cesarean birth has been associated with higher risk of obesity in offspring, but previous studies have focused primarily on childhood obesity and have been hampered by limited control for confounders. Objective: To investigate the association between cesarean birth and risk of obesity in offspring. Design, Setting, and Participants: A prospective cohort study was conducted from September 1, 1996, to December 31, 2012, among participants of the Growing Up Today Study, including 22 068 offspring born to 15 271 women, followed up via questionnaire from ages 9 to 14 through ages 20 to 28 years. Data analysis was conducted from October 10, 2015, to June 14, 2016. Exposure: Birth by cesarean delivery. Main Outcomes and Measures: Risk of obesity based on International Obesity Task Force or World Health Organization body mass index cutoffs, depending on age. Secondary outcomes included risks of obesity associated with changes in mode of delivery and differences in risk between siblings whose modes of birth were discordant. Results: Of the 22 068 offspring (20 950 white; 9359 male and 12 709 female), 4921 individuals (22.3%) were born by cesarean delivery. The cumulative risk of obesity through the end of follow-up was 13% among all participants. The adjusted risk ratio for obesity among offspring delivered via cesarean birth vs those delivered via vaginal birth was 1.15 (95% CI, 1.06-1.26; P = .002). This association was stronger among women without known indications for cesarean delivery (adjusted risk ratio, 1.30; 95% CI, 1.09-1.54; P = .004). Offspring delivered via vaginal birth among women who had undergone a previous cesarean delivery had a 31% (95% CI, 17%-47%) lower risk of obesity compared with those born to women with repeated cesarean deliveries. In within-family analysis, individuals born by cesarean delivery had 64% (8%-148%) higher odds of obesity than did their siblings born via vaginal delivery. Conclusions and Relevance: Cesarean birth was associated with offspring obesity after accounting for major confounding factors. Although additional research is needed to clarify the mechanisms underlying this association, clinicians and patients should weigh this risk when considering cesarean delivery in the absence of a clear indication.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.