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Am J Clin Nutr. 2011 Jun;93(6):1344-7. doi: 10.3945/ajcn.110.010033. Epub 2011 Apr 20.

Cesarean delivery is associated with an increased risk of obesity in adulthood in a Brazilian birth cohort study.

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  • 1Department of Pediatrics, Hospital de Clínicas de Porto Alegre, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.



Obesity is epidemic worldwide, and increases in cesarean delivery rates have occurred in parallel.


This study aimed to determine whether cesarean delivery is a risk factor for obesity in adulthood in a birth cohort of Brazilian subjects.


We initiated a birth cohort study in Ribeirão Preto, southeastern Brazil, in 1978. A randomly selected sample of 2057 subjects from the original cohort was reassessed in 2002-2004. Type of delivery, birth weight, maternal smoking, and schooling were obtained after birth. The following data from subjects were collected at 23-25 y of age: body mass index (BMI; in kg/m(2)), physical activity, smoking, and income. Obesity was defined as a BMI ≥30. A Poisson multivariable model was performed to determine the association between cesarean delivery and BMI.


The obesity rate in adults born by cesarean delivery was 15.2% and in those born by vaginal delivery was 10.4% (P = 0.002). Adults born by cesarean delivery had an increased risk (prevalence ratio: 1.58; 95% CI: 1.23, 2.02) of obesity at adulthood after adjustments.


We hypothesize that increasing rates of cesarean delivery may play a role in the obesity epidemic worldwide.

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