Do babies delivered by cesarean section have a higher risk of developing chronic diseases later in life?
According to new research, recent studies suggest it is a good idea for health care providers to discuss with expectant parents the risk of babies born through cesarean section for later developing obesity, asthma, and diabetes.
It is true that a cesarean section procedure is sometimes a medical necessity, or even an emergency. But increasingly, the choice is made in calmer moments.
The number of C-sections done at the mothers' request is growing worldwide. Repeat cesarean is not necessarily indicated medically for women with otherwise low obstetrical risk, but there is a 90% rate of repeat cesareans among US women giving birth who have had a prior cesarean.
Both cesarean and vaginal deliveries come with well-known risks. But recent studies link C-section to long-term child chronic disease.
Rates of caesarean section are rising, with maternal request and repeat caesarean accounting for a large proportion in some countries
Caesarean delivery has been linked to increased risk of childhood obesity, asthma, and type 1 diabetes
The evidence on these risks has not been reviewed in clinical guidelines
Knowing about child health risks could change decisions when caesarean is not a medical necessity
A new paper in the British Medical Journal by Jan Blustein, MD, PhD, of New York University’s Wagner School and a professor of Medicine and Population Health at NYU School of Medicine and Jianmeng Liu of Peking University, supplies evidence from a variety of sources.
Sources included observational studies where researchers locate large samples of children, assess the extent of disease, and look back to see how the children were delivered. They also include a clinical trial, in which mothers were prospectively randomized to undergo cesarean or vaginal delivery.
The authors found that the evidence warrants concerns that C-section may lead to worse long-term child health.
“It’s time to update the guidelines to include information about possible risks to long-term child health,” comments Dr. Blustein.
Blustein acknowledges that the evidence linking cesarean to worse child health is not decisive.
“It is clear that cesarean-born children have worse health, but further research is needed to establish whether it is the cesarean that causes disease, or whether other factors are at play,” Dr. Blustein says. “Getting definitive answers will take many years of further research. In the interim, we must make decisions based on the evidence that we have. To me, that evidence says that it is reasonable to believe that cesarean has the potential for long-term adverse health consequences for children.”
J. Blustein, J. Liu. Time to consider the risks of caesarean delivery for long term child health. BMJ, 2015; 350 (jun09 3): h2410 DOI: 10.1136/bmj.h2410