Does cesarean birth raise baby’s risk of asthma, diabetes and obesity?

Does cesarean birth raise baby’s risk of asthma, diabetes and obesity?

A recent article in Reuters Health News suggests Cesarean section delivery may leave babies vulnerable to chronic health problems such as asthma, diabetes and obesity, a new study hints.Much of the research included in the study cannot prove that C-section delivery causes medical issues later in life.

“the link is strong enough that mothers should discuss the risk with their doctor or midwife when weighing whether to proceed with a C-section, particularly when a vaginal delivery may be possible” Lead study author Dr. Jan Blustein.

“It’s a discussion that’s important to have in view of the rising rate of C-sections,” said Blustein, a professor of medicine and health policy at New York University. “The magnitude of risk elevation is small, but even when we are talking about increasing the risk modestly, we still need to talk about it.”

In a report online June 10 in the British Medical Journal, Blustein and co-author Jianmeng Liu of the Institute of Reproductive and Child Health in Beijing note that C-section rates are unnecessarily high in some countries in part because some surgical deliveries are elective, done only because women requested them, and because mothers who have one C-section are often encouraged to deliver this way again.

About 9.5% of C-section babies develop asthma, compared with 7.9% for vaginal births. Obesity develops in 19.4% of children delivered by C-section, compared with just 15.8% for vaginal births, the study found.

Why C-sections might lead to chronic health problems isn’t clearly established, but one theory is that women may pass healthy bacteria to babies during a vaginal delivery that protects against disease, Blustein said. Another possibility is that hormones released during labour might play a role in minimizing risk.

Most of the studies included in the analysis did not have enough information for researchers to account for characteristics of mothers, such as obesity, that might precipitate C-section delivery or be linked to the child’s later health problems, the study authors caution.

Based on the mounting evidence linking C-sections to chronic health problems, however, the authors recommend that the American College of Obstetrics and Gynecology (ACOG) and the U.K.’s National Institute for Health and Care Excellence revise practice guidelines to include the long-term risk of chronic disease.

Last year, ACOG issued new guidelines aimed at reducing unnecessary C-sections by encouraging doctors to let labour progress longer and consider non-surgical options to help women deliver vaginally. A large number of observational studies are pointing in the same direction. “We should be having a conversation with patients about the risk when they are considering a truly elective c-section.”

By Lisa Rapaport

Reuters Health Information

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