Risk of Overweight and Obesity in Children under 6 Years Old Following Cesarean Delivery: A Systematic Review and Meta-analysis of Cohort Studies
Bibliographic record
Abstract
Abstract Background Cesarean delivery is considered as a potential risk factor for childhood overweight/obesity; however, its risk magnitude remains unknown. To estimate the risk of being overweight/obese in children under 6 years old following cesarean delivery. Methods Three English and two Chinese databases were searched. The quality of studies was appraised using the Newcastle-Ottawa Scale. Meta-analyses were conducted to estimate the pooled rates and relative risk (RR) of overweight/obesity, with RR estimates to compare the risks between children delivered by cesarean section and children delivered vaginally under 6 years old. Results Eighteen cohort studies with a total of 125,042 children under 6 years old were included. Of them, 33,551 children were delivered by cesarean section. The rates of pooled estimate of overweight combined with obesity, overweight alone, and obesity alone in children delivered by cesarean section were 18.2%, 14.1%, and 8.6%, respectively, while corresponding rates in children delivered vaginally were 14.0%, 12.5%, and 6.6%. Cesarean delivery was associated with significantly increased risks of childhood overweight combined with obesity (RR 1.18, 95% confidence interval [CI] 1.13–1.23), overweight alone (RR 1.09, 95% CI 1.02–1.17), and obesity alone (RR 1.26, 95% CI 1.13–1.40) as compared with vaginal delivery. Subgroup analyses showed a low degree of heterogeneity among all subgroups. Sensitivity analysis showed that overall estimates remained essentially the same when omitting one study at a time. Conclusion Children delivered by cesarean section may have an increased risk of overweight and / or obesity than children delivered vaginally in the first 6 years of life.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.011 | 0.026 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.013 | 0.032 |
| Bibliometrics | 0.007 | 0.008 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.001 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".