Department of Maternal and Child Health, School of Public Health, Sun Yat-Sen University, Guangzhou 510080, China.
Department of Nutrition and Food Hygiene, Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou 510515, China.
Int J Environ Res Public Health. 2017 Dec 20;14(12):1609. doi: 10.3390/ijerph14121609.
Previous research on the association between cesarean section (CS) and childhood obesity has yielded inconsistent findings. This study assessed the secular trend of CS and explored the relationship between CS and the risks of overweight and obesity in Chinese children and adolescents. Data came from a national multicenter school-based study conducted in seven provinces of China in 2013. Covariate data including weight, height and delivery mode were extracted. Poisson regression was applied to determine the risk ratios (RRs) and 95% confidence intervals (CIs) for the risks of overweight and obesity associated with the delivery mode. A total of 18,780 (41.2%) subjects were born by CS between 1997 and 2006. The rate of CS increased from 27.2% in 1997 to 54.1% in 2006. After adjusting for major confounders, the RRs (95% CI) of overweight and obesity among subjects born by CS were 1.21 (1.15 to 1.27) and 1.51 (1.42 to 1.61), respectively. Similar results were observed in different subgroups stratified by sex, age, and region. In summary, the CS rate increased sharply in China between 1997 and 2006. CS was associated with increased risks of overweight and obesity in offspring after accounting for major confounding factors.
先前关于剖宫产（CS）与儿童肥胖之间关联的研究结果并不一致。本研究评估了 CS 的时间趋势，并探讨了 CS 与中国儿童和青少年超重和肥胖风险之间的关系。数据来自于 2013 年在中国七个省份进行的一项全国多中心基于学校的研究。提取了包括体重、身高和分娩方式在内的协变量数据。应用泊松回归确定与分娩方式相关的超重和肥胖风险的风险比（RR）和 95%置信区间（CI）。共有 18780（41.2%）名受试者在 1997 年至 2006 年间通过 CS 分娩。CS 的比例从 1997 年的 27.2%上升到 2006 年的 54.1%。在调整了主要混杂因素后，CS 分娩的受试者中超重和肥胖的 RR（95%CI）分别为 1.21（1.15 至 1.27）和 1.51（1.42 至 1.61）。在按性别、年龄和地区划分的不同亚组中也观察到了类似的结果。总之，1997 年至 2006 年间，中国 CS 的比例急剧上升。在考虑了主要混杂因素后，CS 与后代超重和肥胖的风险增加有关。
