{"doi":"10.1001/jamanetworkopen.2020.2605","title":"Association of Birth by Cesarean Delivery With Obesity and Type 2 Diabetes Among Adult Women","abstract":"Importance: Cesarean delivery is associated with an increased risk of childhood obesity in offspring. However, whether this increased risk also includes obesity-associated conditions remains unclear. Objective: To evaluate the association of birth by cesarean delivery with offspring's risks of obesity and type 2 diabetes in adulthood. Design, Setting, and Participants: This prospective cohort study compared the incidence of obesity and type 2 diabetes between birth by cesarean delivery and vaginal delivery among 33 226 women participating in the Nurses' Health Study II who were born between 1946 and 1964, with follow-up through the end of the 2013-2015 follow-up cycle. Participants' mothers provided information on mode of delivery and pregnancy characteristics. Participants provided information every 2 years on weight and diagnosis of type 2 diabetes. Relative risks of obesity and type 2 diabetes were estimated using log-binomial and proportional hazards regression accounting for maternal body mass index and other confounding factors. Statistical analysis was performed from June 2017 to December 2019. Exposure: Birth by cesarean delivery compared with birth by vaginal delivery. Main Outcomes and Measures: Risk of obesity and incidence of type 2 diabetes. Results: At baseline, the participants' mean (SD) age was 33.8 (4.6) years (range, 24.0-44.0 years). A total of 1089 of the 33 226 participants (3.3%) were born by cesarean delivery. After 1 913 978 person-years of follow-up, 12 156 (36.6%) women were obese and 2014 (6.1%) had received a diagnosis of type 2 diabetes. Women born by cesarean delivery were more likely to be classified as obese and to have received a diagnosis of type 2 diabetes during follow-up. The multivariable-adjusted relative risk of obesity among women born by cesarean vs vaginal delivery was 1.11 (95% CI, 1.03-1.19). The multivariable-adjusted hazard ratio for type 2 diabetes among women born by cesarean vs vaginal delivery was 1.46 (95% CI, 1.18-1.81); this association remained significant after additional adjustment for participant's own body mass index (relative risk, 1.34 [95% CI, 1.08-1.67]). These associations persisted when analyses were restricted to women at low risk of cesarean delivery based on maternal characteristics. Conclusions and Relevance: This study suggests that women born by cesarean delivery may have a higher risk than women born by vaginal delivery of being obese and developing type 2 diabetes during adult life.","journal":"JAMA Network Open","year":2020,"id":55785,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":90,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9432,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2020-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":289005,"name":"Nerea Martín‐Calvo","orcid":"0000-0001-7549-1455","position":1,"is_corresponding":false},{"id":267715,"name":"Changzheng Yuan","orcid":"0000-0002-2389-8752","position":2,"is_corresponding":false},{"id":289006,"name":"Mariel Arvizu","orcid":"0000-0003-1860-7276","position":3,"is_corresponding":false},{"id":104574,"name":"Janet W. Rich‐Edwards","orcid":"0000-0001-5066-8808","position":4,"is_corresponding":false},{"id":264205,"name":"Karin B. Michels","orcid":"0000-0001-5137-5505","position":5,"is_corresponding":false},{"id":246331,"name":"Qi Sun","orcid":"0000-0002-8480-1563","position":6,"is_corresponding":false},{"id":104573,"name":"Jorge E. Chavarro","orcid":"0000-0002-4436-9630","position":0,"is_corresponding":true}],"reference_count":50,"raw_metadata":null,"created_at":"2026-07-18T21:05:29.672878Z","pmid":"32282045","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}