Association Between Birth by Cesarean Delivery With Obesity, Type 2 Diabetes Among Adult Women

Women born by cesarean delivery may have a higher risk of being obese and developing type 2 diabetes during adult life compared with women born by vaginal delivery, according to a study in JAMA Network Open.

The objective of the study was to evaluate the association between birth by cesarean delivery with the offspring's risks of obesity and type 2 diabetes in adulthood. The cohort study compared the incidence of obesity and type 2 diabetes among 33,226 women participating in the Nurses' Health Study II who were born between 1946 and 1964. Follow-up was conducted between the end of 2013 and 2015.

The participants' mothers provided information on their mode of delivery and pregnancy characteristics and the participants provided information every 2 years on weight and diagnosis of type 2 diabetes. Risks of obesity and type 2 diabetes were estimated using log-bionomial and proportional hazards regression accounting for maternal body mass index and other cofounding factors. A statistical analysis was performed between June 2017 and December 2019.

Results from the study found that participants' mean age was approximately 34 years, and a total of 1089 of the 33,226 participants were born by cesarean delivery. After approximately 1.9 million person-years of follow-up, 36.6% of women were obese and 6.1% had received a diagnosis of type 2 diabetes.

Women born by cesarean delivery were more likely to be classified as obese and to have received a diagnosis of type 2 diabetes during follow-up, according to study authors. The multivariable-adjusted relative risk of obesity among women born by cesarean versus vaginal delivery was 1.11, whereas the multivariable-adjusted hazard ratio for type 2 diabetes among women born by cesarean versus vaginal delivery was 1.46.

These assocations remained significant after additional adjustment for participant's own body mass index, according to the study authors. When analyses were restricted to women at low risk of cesarean delivery based on maternal characteristics, these associations persisted.

REFERENCE

Chavarro JE, Martín-Calvo N, Yuan C, et al. Association of Birth by Cesarean Delivery with Obesity and Type 2 Diabetes Among Adult Women. JAMA Netw Open. 2020;3(4):e202605. doi:10.1001/jamanetworkopen.2020.2605.