Objective: African American children are at higher risk of obesity than White children and African American women are more likely to undergo caesarean-section (CS) delivery than White women. CS is associated with childhood obesity; however, little is known whether this relationship varies by race. We examined if the association of CS with obesity at age 2 years varied by race.
Design: Longitudinal birth cohort.
Setting: Birth cohort conducted in a health care system in metropolitan Detroit, Michigan with follow-up at age 2 years.
Participants: 639 birth cohort participants; 367 children (57.4%) were born to African American mothers and 230 (36.0%) children were born via CS.
Main Outcome Measures: Obesity defined as body mass index ≥95th percentile at age 2 years.
Results: Slightly more children of African American (n=37; 10.1%) than non-African American mothers (n=18; 6.6%) were obese (P=.12). There was evidence of effect modification between race and delivery mode with obesity at age 2 years (interaction P=.020). In children of African American mothers, CS compared to vaginal birth was associated with a significantly higher odds of obesity (aOR=2.35 (95% CI: 1.16, 4.77), P=.017). In contrast, delivery mode was not associated with obesity at age 2 years in children of non-African American mothers (aOR=.47 (95% CI: .13, 1.71), P=.25).
Conclusions: There is evidence for a race-specific effect of CS on obesity at age 2 years; potential underlying mechanisms may be racial differences in the developing gut microbiome or in epigenetic programming. Future research is needed to determine if this racial difference persists into later childhood.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4738856 | PMC |
| http://dx.doi.org/10.18865/ed.26.1.61 | DOI Listing |
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