As more and more caesareans are scheduled around the world, new research proves that this operation promotes overweight and obesity in babies.
According to a new study published in the JAMA, Caesarean delivery was associated with a risk of overweight and obesity in children from 12 months, but only when surgery was scheduled. Later, these babies also had gut microbiota problems such as celiac disease.
"Caesarean delivery has already been associated with being overweight and obesity in young children," the researchers explain in a preamble. "However, few studies have looked separately at emergency caesarean delivery and scheduled caesarean delivery," they continued.
Among 727 infants analyzed, 30.5% (222) were born by caesarean section, of which 33.3% (74) were scheduled caesareans. The prevalence of overweight and overweight at 12 months of age was 12.2% (89) and 2.3% (17), respectively. Compared with normal delivery, scheduled delivery was therefore significantly associated with risk of being overweight at 12 months of age. Most overweight children also suffered from celiac disease (gluten intolerance). The mothers had been recruited from two large public hospitals in Singapore.
"Our study proves the existence of an association between elective caesarean delivery and an increased risk of overweight in children as young as 12 months," the researchers conclude. "Clinicians are encouraged to inform patients of the consequences that caesareans can have on their baby," they insist.
The number of births by caesarean section has doubled
Between 2000 and 2015, the total number of births by caesarean section in the world increased from 12% to 21%, even exceeding 40% in 15 countries (Dominican Republic, Brazil, Egypt, Turkey, Venezuela, Chile, Colombia, Iran ...) . Caesarean section practice has increased on average by 6% per year in Asia, from 7.2% to 18.1% of births. The increase is approximately 2% per year in North America (32% of Caesareans in 2015) and Western Europe (26.9%).
In France, the caesarean section rate has been stable since 2010 (20.4% in 2016), after having increased significantly over the previous twenty years. But the number of caesareans can vary from single to double depending on the department. Guyana, the Alpes de Haute-Provence, Lozère and Haute-Corse register more than 23 cesareans for every 100 births while Yonne, Loir-et-Cher, Doubs, Guadeloupe, Jura and Haute-Corse Saône practice less than 15 per 100 births.
Modify neonatal physiology
"A Caesarean section can be a life-saving intervention when medically indicated, but this intervention can also have short and long-term effects on the health of women and children," recalled last October a large group of gynecologists, very worried about these numbers.
They stated: "It is increasingly evident that babies born by cesarean section have different hormonal, physical, bacterial, and medical exposures, and that these exposures can subtly alter neonatal physiology." Short-term risks include altered immune development , an increased likelihood of allergy, atopy and asthma, and reduced intestinal microbial diversity.The persistence of these risks to older ages is less well studied, although an association between the use of Caesarean section and a higher incidence of late childhood obesity and asthma is frequently reported. "