Abstract
Objective
To study the relationship between cesarean Delivery (CD) and overweight in preschool children, considering the presence of birth aspects and demographic characteristics that have been associated with the risk of excess weight.
Methods
This retrospective cross-sectional analysis used representative data of children from 2 to 6 years of age at municipal daycare centers in Taubaté, São Paulo, Brazil. The sample included 752 preschoolers. Weight and height were collected in daycare centers, and the nutritional status classification was performed using z scores of Body Mass Index (zBMI). Data analysis was performed in the bivariate and multivariate manner, the latter with the inclusion of another possible risk factor. Adjustments were made for daycare centers time, sex, birth length and weight and maternal schooling.
Results
The mean age of preschool children was 4.7 years, and 53.8% were boys. The prevalence of overweight children was 21.7%. The median zBMI of the children born by CD was higher than that of vaginal Delivery (p = 0.0194). The prevalence of overweight showed association with CD (p = 0.0196; PR = 1.397 with 95% CI of 1065–1831). Logistic binary multivariate regression analysis confirmed the association, even in the presence of other possible risk factors (CR: 1.580, 95% CI: 1.072–2.330).
Conclusion for Practice
Birth by CD is one of the factors that are associated with the early development of overweight in preschoolers.
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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP), Process n. 2012/24064-5.
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AFL: Contributed to the study design, statistical analysis and article writing. Reviewed and edited the manuscript and prepared the tables. TCM: Contributed to the study design, data collection, statistical analysis and article writing. VGN: Contributed to the study design, data collection, statistical analysis, and general review of the manuscript. CJB: Contributed to the development of the hypothesis, design of the study, conducted analysis and general review of manuscript. CL: Contributed to the development of the hypothesis, design of the study, conducted analysis and general review of manuscript. Supervised the research team and reviewed the analysis, discussion and developed final of manuscript.
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Authors declare that all human and animal studies have been approved by the appropriate ethics committee and have therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments. The accomplishment of this study is in agreement with the resolution CNS 196/96 and was approved by the Committee of Ethics in Research of the School of Public Health of the University of São Paulo, document no 361/09, and by the Committee of Ethics in Research from the University of Taubaté, CEP/UNITAU no 0002/05.
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All children in the research were informed about the study and the procedures that would be performed at the time of the anthropometric assessment. Children’s only was informed after the authorization evidenced by the signing of the Free and Informed Consent Form by parents or legal guardians to participate in the study.
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Lopes, A.F., Machado, T.C., Nascimento, V.G. et al. Cesarean Delivery and Risk of Excess Weight Among Brazilian Preschool Children. Matern Child Health J 26, 1305–1311 (2022). https://doi.org/10.1007/s10995-021-03295-0
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DOI: https://doi.org/10.1007/s10995-021-03295-0