Cesarean Section Is Associated with Increased Peripheral and Central Adiposity in Young Adulthood: Cohort Study

Author(s)

Mesquita, Denise N. ^[1] ; Barbieri, Marco A. ^[1] ; Goldani, Helena A. S. ^[2] ; Cardoso, Viviane C. ^[1] ; Goldani, Marcelo Z. ^[2] ; Kac, Gilberto ^[3] ; Silva, Antonio A. M. ^[4] ; Bettiol, Heloisa ^[1]

Affiliation

^[1] Univ Sao Paulo, Fac Med Ribeirao Preto, Dept Puericulture & Pediat, BR-14049 Ribeirao Preto - Brazil

^[2] Univ Fed Rio Grande do Sul, Fac Med, Dept Pediat & Puericulture, Porto Alegre, RS - Brazil

^[3] Univ Fed Rio de Janeiro, Dept Social & Appl Nutr, Rio De Janeiro - Brazil

^[4] Univ Fed Maranhao, Dept Publ Hlth, Sao Luis - Brazil

• Document type: Journal article
• Source: PLoS One; v. 8, n. 6 JUN 27 2013.
• Web of Science Citations: 22

Abstract

Background: Cesarean section (CS) has been associated with obesity, measured by body mass index (BMI), in some studies. It has been hypothesized that this association, if causal, might be explained by changes in gut microbiota. However, little is known about whether CS is also associated with increased adiposity as measured by indicators other than BMI. Objective: To assess the association between CS and indicators of peripheral and central adiposity in young adults. Methods: The study was conducted on 2,063 young adults aged 23 to 25 years from the 1978/79Ribeirao Preto birth cohort, Sao Paulo, Brazil. CS was the independent variable. The anthropometric indicators of adiposity were: waist circumference (WC), waist-height ratio (WHtR), waist-hip ratio (WHR), tricipital skinfold (TSF), and subscapular skinfold (SSF). The association between CS and indicators of adiposity was investigated using a Poisson model, with robust adjustment of variance and calculation of incidence rate ratio (IRR) with 95% confidence interval (95% CI), and adjustment for birth variables. Results: Follow-up rate was 31.8%. The CS rate was 32%. Prevalences of increased WC, WHtR, WHR were 32.1%, 33.0% and 15.2%, respectively. After adjustment for birth variables, CS was associated with increased risk of adiposity when compared to vaginal delivery: 1.22 (95% CI 1.07; 1.39) for WC, 1.25 (95% CI 1.10; 1.42) for WHtR, 1.45 (95% CI 1.18; 1.79) for WHR, 1.36 (95% CI 1.04; 1.78) for TSF, and 1.43 (95% CI 1.08; 1.91) for SSF. Conclusion: Subjects born by CS had a higher risk for increased peripheral and central adiposity during young adult age compared to those born by vaginal delivery. The association of CS with adiposity was consistently observed for all indicators and was robust after adjustment for a variety of early life confounders. (AU)

• FAPESP's process: 00/09508-7 - From perinatal health to health of the young adult: study of cohort born in 1978/79 in the hospitals of Ribeirão Preto, SP
• Grantee: Marco Antonio Barbieri
• Support Opportunities: Research Projects - Thematic Grants