ArticleJAMA network open2020
Association of Birth by Cesarean Delivery With Obesity and Type 2 Diabetes Among Adult Women.
Article in JAMA network open, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 37 papers, 3 of them syntheses that pooled it.
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Who cites it
37 citing papers in PubMed, 3 syntheses or guidelines pooled it, 85 citations in OpenAlex.
- 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
- Pediatrics Consequences of Caesarean Section-A Systematic Review and Meta-Analysis.International journal of environmental research and public health · 2020Pooled it
- A synbiotic intervention modulates meta-omics signatures of gut redox potential and acidity in elective caesarean born infants.BMC microbiology · 2021Trial
- The Critical Period Microbiota Shape Brain Plasticity.Research square · 2026Article
- The Critical Period Microbiota Shape Brain Plasticity.bioRxiv : the preprint server for biology · 2026Article
- Review
- The Acari Hypothesis, VIII: the human apocrine-mammary-microbiota axis andFrontiers in microbiology · 2026Article
- Article
- Caesarean deliveries and double burden of malnutrition: a multicountry analysis in South and Southeast Asia.Journal of public health (Oxford, England) · 2025Article
- Increased vaginalmSystems · 2025Article
- Microbiological Foundations to Optimise Intrinsic Capacity and Promote Healthy Ageing: An Integration Into the Life Course Approach.Aging cell · 2025Review
- Can Vaginal Seeding at Birth Improve Health Outcomes of Cesarean Section-Delivered Infants? A Scoping Review.Microorganisms · 2025Review
- Development and validation of machine learning models for predicting post-cesarean pain and individualized pain management strategies: a multicenter study.BMC anesthesiology · 2025Article
- Association between aspirin use and the risk of incident nonalcoholic fatty liver disease.European journal of epidemiology · 2025Article
- Early-life gut mycobiome core species modulate metabolic health in mice.Nature communications · 2025Article
- Lactobacillus Helveticus Improves Controlled Cortical Impact Injury-Generated Neurological Aberrations by Remodeling of Gut-Brain Axis Mediators.Neurochemical research · 2024Article
- Helicobacter pylori seropositivity associates with hyperglycemia, but not obesity, in Danish children and adolescents.BMC medicine · 2024Article
- Is There Evidence to Support Probiotic Use for Healthy People?Advances in nutrition (Bethesda, Md.) · 2024Review
- Pre-pregnancy body mass index and caesarean section in Andean women in Peru: a prospective cohort study.BMC pregnancy and childbirth · 2024Article
Corrections and comments
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Authors and funding
7 authors at 3 institutions in 3 countries.
Funding
Abstract
Importance: Cesarean delivery is associated with an increased risk of childhood obesity in offspring. However, whether this increased risk also includes obesity-associated conditions remains unclear. Objective: To evaluate the association of birth by cesarean delivery with offspring's risks of obesity and type 2 diabetes in adulthood. Design, Setting, and Participants: This prospective cohort study compared the incidence of obesity and type 2 diabetes between birth by cesarean delivery and vaginal delivery among 33 226 women participating in the Nurses' Health Study II who were born between 1946 and 1964, with follow-up through the end of the 2013-2015 follow-up cycle. Participants' mothers provided information on mode of delivery and pregnancy characteristics. Participants provided information every 2 years on weight and diagnosis of type 2 diabetes. Relative risks of obesity and type 2 diabetes were estimated using log-binomial and proportional hazards regression accounting for maternal body mass index and other confounding factors. Statistical analysis was performed from June 2017 to December 2019. Exposure: Birth by cesarean delivery compared with birth by vaginal delivery. Main Outcomes and Measures: Risk of obesity and incidence of type 2 diabetes. Results: At baseline, the participants' mean (SD) age was 33.8 (4.6) years (range, 24.0-44.0 years). A total of 1089 of the 33 226 participants (3.3%) were born by cesarean delivery. After 1 913 978 person-years of follow-up, 12 156 (36.6%) women were obese and 2014 (6.1%) had received a diagnosis of type 2 diabetes. Women born by cesarean delivery were more likely to be classified as obese and to have received a diagnosis of type 2 diabetes during follow-up. The multivariable-adjusted relative risk of obesity among women born by cesarean vs vaginal delivery was 1.11 (95% CI, 1.03-1.19). The multivariable-adjusted hazard ratio for type 2 diabetes among women born by cesarean vs vaginal delivery was 1.46 (95% CI, 1.18-1.81); this association remained significant after additional adjustment for participant's own body mass index (relative risk, 1.34 [95% CI, 1.08-1.67]). These associations persisted when analyses were restricted to women at low risk of cesarean delivery based on maternal characteristics. Conclusions and Relevance: This study suggests that women born by cesarean delivery may have a higher risk than women born by vaginal delivery of being obese and developing type 2 diabetes during adult life.
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