Maternal delivery choice may affect the risk of early childhood overweight, according to research published in JAMA Network Open.

A team of researchers compiled data from the Growing Up in Singapore Toward Healthy Outcomes study, a prospective mother-child birth cohort study, to determine whether elective or emergency cesarean delivery was linked to risk of early childhood overweight. Elective and emergency cesarean delivery were analyzed separately against vaginal delivery.

At 12 months, body mass index (BMI)-for-age z scores were calculated; BMI status was defined as z-score standard deviations of more than 1 and less than or equal to 2 for at risk of overweight and more than 2 for overweight.

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Of the 1237 recruited mother-child pairs, 727 (372 male newborns) were included in the primary study; 222 infants were born via cesarean delivery, of which 74 deliveries were elective.

At age 12 months, 89 infants were at risk of overweight, and 17 infants were overweight. After statistical adjustment, the investigators noted a significant link between elective cesarean delivery and risk of overweight at 12 months (odds ratio [OR], 2.05). After additional adjustments, the association was still significant (OR, 2.02). The association between emergency cesarean delivery and childhood overweight was unremarkable.

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“A limitation of our study was the lack of data on paternal characteristics,” the authors noted.

“Additional studies may explore population-specific factors underlying the rising trend in elective [cesarean delivery] rates,” added the authors. “Further validation of these findings may expand our preventive strategy against childhood metabolic disorders. Clinicians may be encouraged to discuss potential long-term implications of elective [cesarean delivery] on child metabolic outcomes with patients who intend to have children.”


Cai M, Loy SL, Tan KH, et al. Association of elective and emergency cesarean delivery with early childhood overweight at 12 months of age. JAMA Netw Open. 2018;1(7):e185025.