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expert reaction to paper investigating the association between Caesarean section births and the risk of obesity in children

The effect of Caesarean section on offspring is the subject of a paper published in JAMA Pediatrics in which the authors report an association between Caesarean section and offspring obesity.


Dr Simon Cork, Research Associate in the Department of Investigative Medicine, Imperial College London, said:

“Studies have previously demonstrated a link between caesarean section delivery and future obesity risk. Although the mechanisms behind this are not fully understood, one theory is the exposure to certain bacteria. Bacteria in the gut play a role in an ever increasing number of functions, including how much and what we eat, and the bacteria present in very early life are heavily influenced by how we’re delivered. Caesarean delivered babies show a gut bacterial population which more closely resembles the bacteria found on skin, compared to a vaginally delivered baby which shows a more typical gut bacterial population.

“With regards to the current paper, although the authors have corrected for certain criteria (e.g. maternal weight), it should be noted that a number of factors could impact the weight of offspring. For example, mothers undergoing caesarean section were more likely to suffer from gestational diabetes and produce offspring with higher birth weights. Furthermore, babies born via caesarean were less likely to be breastfed, which has previously been shown to lead to an increased risk of obesity. Maternal diet, which has also been shown to influence offspring weight, was also not considered. So it cannot be discounted that the increased body weight of children born via caesarean section is down to factors other than the mode of delivery.

“Overall, the literature surrounding this area suggests that there may be a link between caesarean section and obesity, however this link is neither fully proven nor understood. Most often caesarean births are as a result of medical necessity, rather than elective, and as such this risk would outweigh any concerns mothers should have regarding the possibility of future weight issues.”


Association Between Cesarean Birth and Risk of Obesity in Offspring in Childhood, Adolescence, and Early Adulthood’ by Yuan et al. published in JAMA Pediatrics on Tuesday 6th September. 


Declared interests

Dr Simon Cork: No conflicts of interest

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