ArticleJournal of epidemiology and community health2020
Caesarean delivery is associated with higher risk of overweight in the offspring: within-family analysis in the SUN cohort.
Article in Journal of epidemiology and community health, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.
What it found
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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
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Who cites it
7 citing papers in PubMed, 1 synthesis or guideline pooled it, 11 citations in OpenAlex.
- 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
- Intrapartum caesarean delivery and childhood BMI trajectories in relation to the infant gut microbiome in the VDAART prospective birth cohort.EBioMedicine · 2026Article
- The Rising Global Cesarean Section Rates and Their Impact on Maternal and Child Health: A Scoping Review.Journal of clinical medicine · 2025Review
- Cohort Profile Update: The 'Seguimiento Universidad de Navarra' (SUN) study after 24 years of follow-up.International journal of epidemiology · 2025Article
- Birthmode and environment-dependent microbiota transmission dynamics are complemented by breastfeeding during the first year.Cell host & microbe · 2024Article
- Cesarean Delivery and Risk of Excess Weight Among Brazilian Preschool Children.Maternal and child health journal · 2022Article
- Association of mode of delivery with offspring pubertal development in Project Viva: a prospective pre-birth cohort study in the USA.Human reproduction (Oxford, England) · 2021Article
Corrections and comments
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Authors and funding
6 authors at 5 institutions in 2 countries.
Funding
Abstract
backgroundMost studies assessing the association between caesarean delivery (CD) and childhood overweight/obesity have failed to account for important confounders, such as maternal prepregnancy body mass index (BMI) or the indication of the CD. Furthermore, within-family analyses have reported contradictory results. We aimed at evaluating the association between CD and offspring's risk of overweight/obesity while adjusting for important confounders and accounting for correlations between siblings.
methodsWomen in the 'Seguimiento Universidad de Navarra' cohort provided structured information regarding their pregnancy history and their children's health through online cross-sectional questionnaires. We calculated adjusted differences in BMI z-score and risk ratios (RR) for offspring's overweight/obesity associated with CD, with hierarchical models to account for correlations between siblings. We also performed a within-family analysis in 341 siblings who were discordant in delivery mode, using conditional multivariable logistic regression.
resultsAmong the 2791 children analysed, those born by CD had higher average BMI z-scores (difference: 0.17; 95% CI 0.07 to 0.27) and higher risk of overweight/obesity (RR: 1.32, 95% CI 1.05 to 1.65) than children born vaginally. The association did not differ by maternal characteristics or offspring's age strata, and the results were consistent in sensitivity analyses. Furthermore, within-family analysis showed that children born by CD had 2.67-fold higher risk of overweight/obesity (95% CI 1.10 to 5.12) than their peers born vaginally.
conclusionChildren born by CD have higher average BMI z-scores and higher risk of overweight/obesity than children born vaginally. The consistency of these findings across multiple approaches to address potential residual confounding likely suggests a true biological effect.
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