Abstract 15885: Can Vaginal Delivery Reduce the Intergenerational Transmission of Overweight and Obesity? Findings From the Boston Birth Cohort
Introduction: It has been hypothesized that the association between mother and child body weight is influenced by mother-to-newborn transmission of microbiota at birth. Birth mode (Cesarean vs. vaginal delivery) alters newborn acquisition of microbiota.
Aim: In this study we aim to examine the independent and joint contributions of birth mode and maternal pre-pregnancy body mass index (BMI; kg/m2) to the development of childhood overweight and obesity (OWOB; age-sex specific BMI≥85th percentile).
Methods: We conducted a prospective analysis using data from racially and ethnically diverse mothers and children (ages 2.0—8.0 yo) in the Boston Birth Cohort. We first examined the association of birth mode with childhood OWOB, and then the joint association of pre-pregnancy BMI and birth mode with childhood OWOB.
Results: Of 2,045 mother-child pairs with data on BMI, 1,441 term deliveries (≥37 weeks) had complete data for our analysis. Compared to vaginally delivered children, Cesarean delivered children had 1.4 (95% CI: 1.1-1.8) times greater odds of developing OWOB in childhood, after adjustment for maternal age at delivery, race/ethnicity, education, air pollution exposure, pre-pregnancy BMI, pregnancy weight gain, and birth weight. Compared to children born vaginally to normal weight mothers, those born vaginally to overweight and obese mothers had, respectively, 1.7 (1.2-2.3) and 1.8 (1.3-2.6) times greater odds of OWOB, and those born by Cesarean to overweight and obese mothers had, respectively, 2.2 (1.5-3.2) and 2.8 (1.9-4.1) times greater odds of OWOB, after multivariable adjustment (Figure).
Conclusions: In the Boston Birth Cohort, birth mode and pre-pregnancy BMI were independently, positively associated with childhood OWOB. These results suggest that vaginal delivery, or exposure to vaginal microbiota in Cesarean delivered newborns, may be an innovative strategy to combat the vicious intergenerational cycle of obesity.
Author Disclosures: N.T. Mueller: None. G. Mao: None. W. Bennet: None. S. Hourigan: None. M. Dominguez-Bello: None. L.J. Appel: None. X. Wang: None.
- © 2016 by American Heart Association, Inc.