Women born by cesarean section at higher risk of type 2 diabetes: JAMA

Women born by cesarean section are at higher risk of developing type 2 diabetes, finds a new study appearing in JAMA.

More than 1.2 million cesarean deliveries are performed yearly in the United States, making it the most common inpatient surgical procedure and accounting for nearly one-third of births nationwide.Cesarean delivery is associated with an increased risk of childhood obesity in offspring. However, whether this increased risk also includes obesity-associated conditions including diabetes remains unclear.

Researchers conducted a study to ascertain whether birth by cesarean delivery associated with obesity and type 2 diabetes in adulthood or not.

They found that women born by cesarean section had a higher risk for developing Type 2 diabetes decades later.There is a clear association between being born by cesarean delivery and increased risks of obesity and type 2 diabetes in adulthood.

This prospective cohort study compared the incidence of obesity and type 2 diabetes between birth by cesarean delivery and vaginal delivery among 33 226 women participating in the Nurses' Health Study II who were born between 1946 and 1964, with follow-up through the end of the 2013-2015 follow-up cycle. Participants' mothers provided information on mode of delivery and pregnancy characteristics. Participants provided information every 2 years on weight and diagnosis of type 2 diabetes. Relative risks of obesity and type 2 diabetes were estimated using log-binomial and proportional hazards regression accounting for maternal body mass index and other confounding factors. Statistical analysis was performed from June 2017 to December 2019.

The main outcomes and measures were risk of obesity and incidence of type 2 diabetes.

The researchers found in this cohort study of 33 226 women that those born by cesarean delivery were 11% more likely to be obese as adults and had a 46% higher risk of developing type 2 diabetes than women born by vaginal delivery.

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. The multivariable-adjusted relative risk of obesity among women born by cesarean vs vaginal delivery was 1.11 (95% CI, 1.03-1.19). The multivariable-adjusted hazard ratio for type 2 diabetes among women born by cesarean vs vaginal delivery was 1.46 (95% CI, 1.18-1.81); this association remained significant after additional adjustment for participant's own body mass index (relative risk, 1.34 [95% CI, 1.08-1.67]). These associations persisted when analyses were restricted to women at low risk of cesarean delivery based on maternal characteristics.

These associations persisted when analyses were restricted to women at low risk of cesarean delivery based on maternal characteristics.

The researchers conclud that women born by cesarean delivery may have a higher risk than women born by vaginal delivery of being obese and developing type 2 diabetes during adult life.

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doi:10.1001/jamanetworkopen.2020.2605