Publication Details

Category Text Publication
Reference Category Journals
DOI 10.1016/j.jpeds.2013.12.044
Title (Primary) Cesarean delivery and risk of childhood obesity
Author Pei, Z.; Heinrich, J.; Fuertes, E.; Flexeder, C.; Hoffmann, B.; Lehmann, I.; Schaaf, B.; von Berg, A.; Koletzko, S.
Source Titel Journal of Pediatrics
Year 2014
Department IMMU
Volume 164
Issue 5
Page From 1068
Page To 1073.e2
Language englisch
Keywords BMI, Body mass index
UFZ wide themes RU3;


To investigate whether birth by cesarean delivery rather than vaginal delivery is a risk factor for later childhood obesity.

Study design

Healthy, full-term infants were recruited. Overweight and obesity were defined using measured weight and height according to World Health Organization reference data. Associations between cesarean delivery and being overweight or obese were investigated at age 2, 6, and 10 years (n = 1734, 1244, and 1170, respectively) by multivariate logistic regression models adjusted for socioeconomic status, child characteristics, and maternal prepregnancy characteristics.


Mothers who gave birth by cesarean delivery (∼17%) had a higher mean prepregnancy body mass index (23.7 kg/m2 vs 22.5 kg/m2), greater mean gestational weight gain (15.3 kg vs 14.5 kg), and shorter mean duration of exclusive breastfeeding (3.4 months vs 3.8 months) compared with those who delivered vaginally. The proportion of obese children was greater in the cesarean delivery group compared with the vaginal delivery group at age 2 years (13.6% vs 8.3%), but not at older ages. Regression analyses revealed a greater likelihood of obesity at age 2 years in the cesarean delivery group compared with the vaginal delivery group at age 2 years (aOR, 1.68; 95% CI, 1.10-2.58), but not at age 6 years (aOR, 1.49; 95% CI, 0.55-4.05) or age 10 years (aOR, 1.16; 95% CI, 0.59-2.29).


Cesarean delivery may increase the risk of obesity in early childhood. Our results do not support the hypothesis that an increasing rate of cesarean delivery contributes to obesity in childhood.

Persistent UFZ Identifier
Pei, Z., Heinrich, J., Fuertes, E., Flexeder, C., Hoffmann, B., Lehmann, I., Schaaf, B., von Berg, A., Koletzko, S. (2014):
Cesarean delivery and risk of childhood obesity
J. Pediatr. 164 (5), 1068 - 1073.e2 10.1016/j.jpeds.2013.12.044