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RCOG response to PLOS study on caesarean birth and obesity

News 6 December 2019

Researchers in Sweden have published findings today that suggest babies born by caesarean are no more likely to become obese in later life than those born vaginally.

Instead, the researchers say a child's risk of obesity depends on a woman’s pre-pregnancy weight along with other factors such as genetics and the environment.

The study analysed data on the body-mass index (BMI) of nearly 100,000 male 18-year-olds divided into categories dependant on whether they were born vaginally, or through elective or emergency caesarean.

Other factors known to influence the weight of a baby, including the mother’s pre-pregnancy weight and maternal and gestational age, were then accounted for.

The findings show there was no evidence to suggest the mode of delivery caused obesity in babies. 5.5% and 5.6% of the men delivered through elective and emergency caesarean birth, respectively, were obese compared to 4.9% of the men who were born vaginally.

The researchers said they were unable to collect information on female populations as they studied data from men who had been drafted for military service in Sweden.

The findings, published in the journal PLOS Medicine, will reassure women that a caesarean birth is not associated with obesity.  

Commenting on these findings, Dr Pat O’Brien, Consultant Obstetrician and Spokesperson for the Royal College of Obstetricians and Gynaecologists, said:

“We welcome the findings from this large scale study which offers reassurance to women who have had, or are preparing for, a caesarean birth, that this procedure is not associated with obesity in their baby.

“This review counters findings from previous small studies that suggested a possible association between caesarean birth and obesity. However, those previous studies did not consider other relevant factors including pre-pregnancy BMI, maternal and gestational age and the presence of diabetes, which all can affect the birth weight of a baby and the chances of having a caesarean. 

“In other words, being overweight is known to increase the risk of both caesarean birth and childhood obesity; this, and other confounding factors, account for the previously suggested link between caesarean birth and offspring obesity.

“Women can be reassured, therefore, that if they have a caesarean birth for any reason, whether planned or emergency, it is not likely to increase the chances that their child will be obese.  

“A caesarean birth can be lifesaving to both mother and baby in emergency situations, and if a woman chooses to have a caesarean birth, she should be supported in her decision.

“Women should be given clear, accurate and evidence based information and the support they need to feel fully confident and comfortable about choosing how to give birth, to ensure the best possible birth.”


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