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Meta-Analysis
. 2023 Mar-Apr;29(2):128-141.
doi: 10.1097/PHH.0000000000001687.

Overweight and Obesity in Adult Birth by Cesarean Section: A Systematic Review With Meta-analysis

Manuela Chiavarini  1 , Benedetta De Socio, Irene Giacchetta, Roberto Fabiani
Affiliations
Meta-Analysis

Overweight and Obesity in Adult Birth by Cesarean Section: A Systematic Review With Meta-analysis

Manuela Chiavarini et al. J Public Health Manag Pract. 2023 Mar-Apr.

Abstract

Context: Overweight/obesity is one of the most important health problems. Birth by cesarean section has been shown to influence long-term health outcomes including obesity.

Objective: The aim of this systematic review-meta-analysis is to update acknowledgment of the increased risk of cesarean section on offspring's overweight/obesity.

Methods: This study follows the PRISMA guidelines. A systematic literature search was conducted on Scopus, PubMed, and Web of Science; we have selected all the articles published until January 2, 2022. For inclusion, studies must have reported either (i) both birth by cesarean section and adult (≥18 years) offspring's body mass index; (ii) cohort or case-control study design; and (iii) a risk estimate. Heterogeneity testing was performed using Cochran's Q and I2 statistics. Publication bias was assessed by the Egger test and the Begg test. Meta-analysis was performed through a random-effects model.

Results: Twelve studies with a combined population of 180 065 subjects were included in the meta-analysis. The overall analysis (N = 19) yielded a combined risk estimate for overweight/obesity of 1.19 (95% CI, 1.08-1.30) and the test of heterogeneity resulted into Q = 57.44 ( I2 = 68.67%, P ≤ .001). The risk of offspring obesity is 1.23 (95% CI, 1.09-1.39) and the test of heterogeneity resulted into Q = 39.55 ( I2 = 69.66%, P ≤ .001). Children born by cesarean section have an increased risk of obesity in adulthood.

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