Friday, April 18, 2014
Obesity in C-section babies?Nadine Wilson
DOCTORS have often warned mothers of the risks involved in doing elective Caesarean sections, but a new study showing that babies born via C-section are more prone to obesity, has further bolstered arguments that vaginal delivery is better for both mother and child.
The study published in the Archives of Disease in Childhood in May of this year, concluded that babies born by Caesarean section are twice as likely to become obese by age three than those who are delivered vaginally. The study was conducted by researchers at the Children's Hospital in Boston who monitored 1,250 women from before their 22nd week of pregnancy up to the time of delivery and thereafter.
The researchers found that after three years, 16 per cent of C-section babies were obese compared to 7.5 per cent of those born vaginally. They also found that those babies born through C-section had higher skin-fold thickness and also had a higher measurement of body fat.
But while the study has received the endorsement of a number of obstetricians/gynaecologists, particularly in the US, those All Woman consulted locally said they did not have any evidence which would back up the findings of the study.
"I cannot see why [all else being equal] a baby born by C-section should be more likely to become obese," said Professor Horace Fletcher who is based at the University Hospital of the West Indies.
The OBGYN noted that C-sections do pose a number of risks to mother and child, but obesity was not listed among them.
"What has been recognised is that those delivered by C-sections electively usually have more respiratory distress soon after birth. Apparently vaginal delivery gives some benefit expressing fluid from the lungs during passage through the birth canal," he said.
A Caesarean section, he noted, also poses anaesthetic risks, intra-operative risks leading to damage of the other structures around the uterus like the bladder and the bowels, and there are also operative risks such as thrombosis, bleeding and infection.
Obstetrician/gynaecologist at the Winchester Surgical and Medical Centre, Dr Leslie Meade, said that while babies born via C-Section are more prone to medical challenges during the early stages of life in comparison to those delivered vaginally, he is not aware that obesity is one of them. He, like Professor Fletcher, pointed to the fact that they are prone to respiratory distress and noted that mothers who undergo emergency C-sections are usually not able to bond with their newborns as much as mothers whose children are delivered vaginally.
"For those that are in emergency, they have to do general anaesthesia, so the bonding process tends not to start as early," he said.
The doctor also pointed to the fact that babies born through C-section are more at risk for meconium aspiration syndrome where they breathe a mixture of meconium and amniotic fluid during delivery. It has also been noted that jaundice is more common in babies born via C-Section that those born vaginally.
"The exact cause, I don't think anybody can rightly say, but these are some of the things that can happen to babies who are born by Caesarean section," he said.
As it relates to obesity in children, Dr Meade said research continues to show that the uterine environment is a predictor as to whether or not a baby is going to be obese or whether they will have any medical problems.
"So that's why we want the mother to have a fairly healthy lifestyle prior to conception and during conception, because we do have in utero programming and more and more research is coming out showing that. So sometimes it might not even be just the Caesarean section, but they were already programmed even before delivery," said the OBGYN.
When contacted, paediatrician Dr Maolynne Miller said she was not aware of babies born via C-section being more obese than those born via vaginal delivery.
"It is really not anything that anybody has made any observations about. I don't think that anybody sees that as a common finding," said the paediatrician, who has over 28 years experience.
Meanwhile, the Boston researchers speculated that the increased level of obesity found in C-section babies might be influenced by bacteria in a newborn's gut, which could be different in C-section babies than in vaginally delivered babies. The bacteria, they said, could affect how calories and nutrients are absorbed from food and promotes insulin resistance, inflammation and fat.
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