AL AIN // Mothers who opt for Caesarean sections may be storing up obesity problems for their children.
A new study suggests C-section babies are 15 per cent more likely to be obese in childhood, prompting doctors in the UAE – where obesity is a major problem – to ask mothers to think hard about using the procedure.
Use of antibiotics to reduce infections, problems with breastfeeding and overweight mothers can increase the chances of childhood obesity.
Researchers looked at data on 22,000 children from birth to their twenties, and at 13,000 children who had brothers or sisters, including 2,000 cases in which the birth method had switched between siblings.
The report showed C-section babies were 64 per cent more likely to be obese as adults than siblings born naturally.
The World Health Organisation recommends Caesarean rates of 19 to 21 per cent, but in the UAE, the figure is closer to 36 per cent.
By contrast, C-section rates at Oasis Hospital in Al Ain are some of the lowest, at 19 per cent.
The study was conducted by researchers from Harvard University, Massachusetts in the United States and published in Jama Pediatrics.
Dr Zakariya Al Salam, head of paediatrics at Oasis Hospital, said that although the study was interesting, a cause-and-effect relationship between C-sections and obesity had not yet been proved.
“Anything we do in the early stages of life and during birth can have long-term consequences for the child,” he said.
“There is a lot of evidence to support the fact that children who are obese are more likely to be delivered by C-section, so it is a backward correlation.
“Mothers who chose to have a C-section are usually rich and have a better socio-economic status and don’t always want to have a vaginal delivery for cosmetic reasons. While this study is interesting, it does not say if this was a factor in these examples.”
C-section procedures can be life-saving when there are complications during childbirth but there is increasing evidence that they can have long-term effects on mother and child.
Experts at Oasis also subscribe to the idea that obese mothers are more likely to have a Caesarean, therefore contributing to a vicious cycle of obesity for their children.
Another possible indicator is a lack of healthy gut bacteria in babies delivered via C-section and a genetic link to obesity among siblings that could contribute to the high prevalence.
“In animal studies, we have seen microbiome bacteria have an effect in obesity and it is more common in the obese,” Dr Al Salam said.
“Friendly bacteria can also affect the metabolism. We know a dose of antibiotics can have an effect on microbiomes in newborns.
“What we do know is mothers who breastfeed are less likely to have obese children, and there is also less risk of diabetes and many other illnesses.”
Caesarean deliveries also carry an extra risk of bleeding and infection, but Dr Christel Brabon, head of obstetrics and gynaecology at Oasis, said it was becoming more common for women to ask for C-sections.
“Breastfeeding can be a little harder for mothers who have just had a C-section as it can take longer for breast milk to come in, and can be uncomfortable,” said Dr Brabon.
“We try to encourage skin-to-skin contact and breastfeeding as soon as possible.
“Obesity has been shown to be linked with low-prevalence of breastfeeding, as formula milk can encourage larger babies.
“If the mother and baby are healthy and safe, a vaginal birth is always preferable. Occasionally, a C-section is unavoidable.”
nwebster@thenational.ae