JAMA study shows choice of delivery mode may influence risk of early childhood weight problem
Could India’s childhood obesity epidemic have anything to do with the rising Caesarean sections, especially in urban areas? it is an association worth exploring, if a study published in the JAMA Open is to be believed.
The study by researchers in Singapore, New Zealand and United Kingdom has concluded: “Choice of delivery mode may influence risk of early childhood overweight. Clinicians are encouraged to discuss potential long-term implications of elective CD on child metabolic outcomes with patients who intend to have children.”
Global cesarean delivery (CD) rates have more than doubled over the past 2 decades, with an increasing contribution from elective CDs. Cesarean delivery has been linked to early childhood overweight and obesity, but limited studies have examined elective and emergency CDs separately. In India C-sec deliveries in urban areas account for 28.2% of births, according to data from the National Family health Survey.
In 2016, the World Health Organization (WHO) estimated that 41 million children younger than 5 years were affected by overweight or obesity worldwide, half of them in Asia. The same report highlighted the importance of addressing obesogenic risk factors in pregnancy and infancy
The figures range from 87.1 per cent of the deliveries in urban Tripura (against 36.4 per cent in government sector) to 25.3 per cent in urban Haryana (the figure in government sector is 10.7 per cent). In Andhra Pradesh, C-secs make up 40.1 per cent of the total deliveries, in Goa, the figure is 31.4 per cent, in Telengana, 58 per cent, and in Tamil Nadu, 34.1 per cent.
India also has a high obesity burden. According to an analysis published last year in the New England Journal of Medicine, India has the second highest number of obese children in the world – 14.4 million. With 20 million obese adult women and 9.8 million obese men, it is one of the top five countries in obesity.
Cesarean delivery has been associated with early childhood overweight and obesity amidst inconclusive evidence. Widely regarded as a public health epidemic, overweight and obesity are linked to childhood and adult morbidities such as cardiovascular disease, type 2 diabetes, orthopedic problems, depression, low self-esteem, and social marginalization. Early childhood overweight and obesity are also likely to persist into middle childhood and adolescence.
In 2016, the World Health Organization (WHO) estimated that 41 million children younger than 5 years were affected by overweight or obesity worldwide, half of them in Asia. The same report highlighted the importance of addressing obesogenic risk factors in pregnancy and infancy, 2 critical developmental periods, with delivery mode implicated as 1 such factor.
