Nascimento por parto cesáreo e risco de excesso de peso aos seis anos de idade: resultados de uma coorte

Abstract

Background: Obesity in children is a public health problem of great magnitude. In recent decades, there has been increasing rates of caesarean sections and obesity, and might have a possible causal relationship between the two events. Objective: To assess the association between cesarean section delivery and overweight at six years of age in a city in northeastern Brazil. Methods: This is a birth cohort conducted with 672 children followed in home visits until the sixth year of age. The outcome variable was overweight obtained by body mass index by age and the main independent variable was cesarean delivery. Were evaluated as covariates: gender; birth weight (<2500g, ≥2500g); duration of breastfeeding (<12 months ≥12 months); calories intake at 72 months (<1935 kcal, ≥1935 kcal); physical activity at school; means of transport to go to school; maternal excessive weight gain during pregnancy; family income (≤1 minimum wage, ≥ 2 minimum wages); maternal schooling; maternal overweight and maternal work. The association of caesarean delivery and overweight was estimated by logistic regression analysis, with the significance level of 5% and its respective 95% confidence interval. Results: Overweight was present in 36.6% of children born by cesarean section compared with 20.2% of those born by vaginal delivery. The association between overweight and cesarean delivery remained statistically significant after adjusting for confounders (OR = 1.96, 95% CI 1.61; 3.22). Conclusion: The results support the assumption that the birth by cesarean delivery is associated with an increased risk of overweight in childhood. Pregnant women should be warned about the increased risk of being overweight for those children born by cesarean delivery.