Risk of early childhood overweight/obesity following cesarean section: A systematic review and meta-analysis.

Background: Cesarean section is considered as a potential risk factor for early childhood (0-6 years) overweight/obesity; however, the precise magnitude of this risk remains unclear.

Objectives: To estimate the risk of early childhood overweight/obesity in children delivered by cesarean section through a systematic review.

Search strategy: MEDLINE, Embase, Web of Science, CNKI and Wanfang databases were searched using a combination of relevant terms for cesarean section, overweight/obesity and children.

Selection criteria: Cohort studies on cesarean section deliveries in children under 6 years of age and overweight/obesity were included.

Data collection and analysis: Two authors independently screened articles and extracted data. The quality of studies was assessed using the Newcastle-Ottawa Scale. Meta-analyses were conducted to estimate the pooled rates and relative risks (RR) of overweight/obesity.

Main results: Twenty cohort studies were included. Cesarean section delivery was associated with significantly increased risks of early childhood overweight/obesity (RR 1.18, 95% confidence interval [CI]: 1.13-1.24), overweight (RR 1.11, 95% CI: 1.04-1.19), and obesity (RR 1.23, 95% CI: 1.12-1.34) compared to vaginal delivery. Subgroup analyses showed low heterogeneity among all subgroups.

Conclusions: Our study suggests that children delivered by cesarean section may have an increased risk of developing overweight/obesity during early childhood compared to those delivered vaginally. These findings highlight the potential impact of delivery mode on the long-term health outcomes of children.