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{"title"=>"Mode of delivery and offspring body mass index, overweight and obesity in adult life: A systematic review and meta-analysis", "type"=>"journal", "authors"=>[{"first_name"=>"Karthik", "last_name"=>"Darmasseelane", "scopus_author_id"=>"56071256500"}, {"first_name"=>"Matthew J.", "last_name"=>"Hyde", "scopus_author_id"=>"24179071100"}, {"first_name"=>"Shalini", "last_name"=>"Santhakumaran", "scopus_author_id"=>"37113131800"}, {"first_name"=>"Chris", "last_name"=>"Gale", "scopus_author_id"=>"56365905200"}, {"first_name"=>"Neena", "last_name"=>"Modi", "scopus_author_id"=>"7005469450"}], "year"=>2014, "source"=>"PLoS ONE", "identifiers"=>{"pui"=>"372629982", "sgr"=>"84896341388", "issn"=>"19326203", "pmid"=>"24586295", "scopus"=>"2-s2.0-84896341388", "doi"=>"10.1371/journal.pone.0087896", "isbn"=>"1932-6203"}, "id"=>"85fdeb16-5bda-3d6a-b0e0-7680856555e9", "abstract"=>"BACKGROUND: It has been suggested that mode of delivery, a potentially powerful influence upon long-term health, may affect later life body mass index (BMI). We conducted a systematic review and meta-analysis of the effect of Caesarean section (CS) and vaginal delivery (VD) on offspring BMI, overweight (BMI>25) and obesity (BMI>30) in adulthood. Secondary outcomes were subgroup analyses by gender and type of CS (in-labour/emergency, pre-labour/elective). METHODS: Using a predefined search strategy, Pubmed, Google Scholar and Web of Science were searched for any article published before 31(st) March 2012, along with references of any studies deemed relevant. Studies were selected if they reported birth characteristics and long-term offspring follow-up into adulthood. Aggregate data from relevant studies were extracted onto a pre-piloted data table. A random-effects meta-analysis was carried out in RevMan5. Results are illustrated using forest plots and funnel plots, and presented as mean differences or odds ratios (OR) and 95% confidence intervals. RESULTS: Thirty-five studies were identified through the search, and 15 studies with a combined population of 163,796 [corrected] were suitable for inclusion in the meta-analysis. Comparing all CS to VD in pooled-gender unadjusted analyses, mean BMI difference was 0.44 kg.m(-2) (0.17, 0.72; p = 0.002), OR for incidence of overweight was 1.26 (1.16, 1.38; p<0.00001) and OR for incidence of obesity was 1.22 (1.05, 1.42; p = 0.01). Heterogeneity was low in all primary analyses. Similar results were found in gender-specific subgroup analyses. Subgroup analyses comparing type of CS to VD showed no significant impact on any outcome. CONCLUSIONS: There is a strong association between CS and increased offspring BMI, overweight and obesity in adulthood. Given the rising CS rate worldwide there is a need to determine whether this is causal, or reflective of confounding influences. SYSTEMATIC REVIEW REGISTRATION: An a priori protocol was registered on PROSPERO (registration number: CRD42011001851).", "link"=>"http://www.mendeley.com/research/mode-delivery-offspring-body-mass-index-overweight-obesity-adult-life-systematic-review-metaanalysis-1", "reader_count"=>97, "reader_count_by_academic_status"=>{"Unspecified"=>5, "Professor > Associate Professor"=>1, "Librarian"=>1, "Researcher"=>20, "Student > Doctoral Student"=>7, "Student > Ph. D. Student"=>12, "Student > Postgraduate"=>4, "Student > Master"=>20, "Other"=>8, "Student > Bachelor"=>12, "Lecturer"=>3, "Lecturer > Senior Lecturer"=>2, "Professor"=>2}, "reader_count_by_user_role"=>{"Unspecified"=>5, "Professor > Associate Professor"=>1, "Librarian"=>1, "Researcher"=>20, "Student > Doctoral Student"=>7, "Student > Ph. D. 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• {"type"=>"COMMENT", "annotationUri"=>"info:doi/10.1371/annotation/16138ff5-9ee4-4429-bb4d-2a63ba598961", "title"=>"Heterogeneity produces an unexpected result in the aggregated data", "body"=>"The authors use a (random effects) weighted average of odds-ratios from different studies and find that this odds-ratio is significantly greater than unity. They therefore conclude that c-sections are correlated with and perhaps even cause overweight or obesity later in life. \n\nIf, instead of a weighted average, one simply takes the aggregated data found at the bottom of Figures 3 and 4 then one draws a qualitatively different conclusion. The aggregated odds-ratio for overweight following CS vs VD is 0.802. The odd-ratio for obesity is 0.876. Both numbers are \"less\" than unity suggesting that c-section is protective against overweight and obesity!\n\nHow can this be? It is because the odds of a c-section vary greatly between studies and the overweight and obesity rates are substantially higher in the studies with low odds of a c-section. This correlation makes c-sections appear to be protective in the aggregated data. Because of this heterogeneity, the weighted average odds-ratio used by the authors is the correct way to look for an effect. \n\nNonetheless, the fact that the two methods yield an opposite effect is troubling. It is indicative of serious confounding factors and I believe it calls into question the strength of the meta-analysis conclusions.", "isRemoved"=>false, "created"=>"2014-03-19T15:03:23Z", "lastModified"=>"2014-03-19T15:03:23Z", "creator"=>{"userId"=>"412867"}, "highlightedText"=>"", "competingInterestStatement"=>{"creatorWasPrompted"=>true, "hasCompetingInterests"=>false}, "parentArticle"=>{"doi"=>"info:doi/10.1371/journal.pone.0087896", "state"=>"published", "journals"=>{"PLoSONE"=>{"journalKey"=>"PLoSONE", "eIssn"=>"1932-6203", "title"=>"PLOS ONE"}}}, "replyTreeSize"=>0, "mostRecentActivity"=>"2014-03-19T15:03:23Z", "replies"=>[]}

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• {"id"=>"438797532856979456", "text"=>"Cesarean babies are 26% more likely to be obese/overwt. Might relate to gut bacteria baby gets via vaginal delivery: http://t.co/gthCo29vNf", "created_at"=>"2014-02-26T22:07:38Z", "user"=>"sxbegle", "user_name"=>"sharon begley", "user_profile_image"=>"http://pbs.twimg.com/profile_images/2602799189/pfqikfot0pbywuygdzfs_normal.jpeg"}
• {"id"=>"438805672055291904", "text"=>"Mode of Delivery and Offspring Body Mass Index, Overweight and Obesity in Adult Life http://t.co/zGwbsDIitb", "created_at"=>"2014-02-26T22:39:59Z", "user"=>"nutrigenomics", "user_name"=>"Michael Müller", "user_profile_image"=>"http://pbs.twimg.com/profile_images/438582412675522562/cMk8c2Cu_normal.jpeg"}
• {"id"=>"438807372463501313", "text"=>"RT @nutrigenomics: Mode of Delivery and Offspring Body Mass Index, Overweight and Obesity in Adult Life http://t.co/zGwbsDIitb", "created_at"=>"2014-02-26T22:46:44Z", "user"=>"EduardoLasso", "user_name"=>"Luis Eduardo Lasso v", "user_profile_image"=>"http://pbs.twimg.com/profile_images/416068479780147200/TxcST-pU_normal.jpeg"}
• {"id"=>"438835875263160320", "text"=>"obesity and caesaerian deliveries, \"strong association\", http://t.co/gSXlyZ0PvZ … ht @nutrigenomics", "created_at"=>"2014-02-27T00:40:00Z", "user"=>"harpersnotes", "user_name"=>"Richard Harper", "user_profile_image"=>"http://pbs.twimg.com/profile_images/1591460992/rjh_photo_2011_1010_normal.jpg"}
• {"id"=>"438874098463027200", "text"=>"帝王切開で生まれた人は太る。Mode of Delivery and Offspring Body Mass Index, Overweight and Obesity in Adult Life: A Systematic … http://t.co/XNeJQRCJGy", "created_at"=>"2014-02-27T03:11:53Z", "user"=>"uranus_2", "user_name"=>"マーキュリー２世", "user_profile_image"=>"http://abs.twimg.com/sticky/default_profile_images/default_profile_5_normal.png"}
• {"id"=>"438883920004644864", "text"=>"RT @uranus_2: 帝王切開で生まれた人は太る。Mode of Delivery and Offspring Body Mass Index, Overweight and Obesity in Adult Life: A Systematic … http://t.c…", "created_at"=>"2014-02-27T03:50:55Z", "user"=>"Noahcatlee", "user_name"=>"Yang Li", "user_profile_image"=>"http://pbs.twimg.com/profile_images/378800000588852812/3257c3a84fc3a26a611837a2e1ed6fb5_normal.jpeg"}
• {"id"=>"438891763126652928", "text"=>"RT @nutrigenomics: Mode of Delivery and Offspring Body Mass Index, Overweight and Obesity in Adult Life http://t.co/zGwbsDIitb", "created_at"=>"2014-02-27T04:22:05Z", "user"=>"DrDylanMacKay", "user_name"=>"Dylan Mackay", "user_profile_image"=>"http://pbs.twimg.com/profile_images/378800000838879484/2e4041ddd953a96eaa9dd8227679442c_normal.jpeg"}
• {"id"=>"438947158990278656", "text"=>"Net bij @sanderdeheer commentaar gegeven op mogelijk hogere kans op overgewicht na keizersnede. Artikel nalezen via http://t.co/sFNd1uUu7v.", "created_at"=>"2014-02-27T08:02:12Z", "user"=>"DokterBertho", "user_name"=>"Dokter Bertho", "user_profile_image"=>"http://pbs.twimg.com/profile_images/415881225493291008/YHYoo6-o_normal.jpeg"}
• {"id"=>"438974317683281920", "text"=>"Fascinating study suggesting #obesity linked to Cesarean section. Surely must be #microbiota? http://t.co/FZE0q77wJj Thanks to @Jopdevrieze.", "created_at"=>"2014-02-27T09:50:07Z", "user"=>"StratRH", "user_name"=>"R. Hansen", "user_profile_image"=>"http://pbs.twimg.com/profile_images/2559557221/qawMoP8t_normal"}
• {"id"=>"438974511376265216", "text"=>"RT @StratRH: Fascinating study suggesting #obesity linked to Cesarean section. Surely must be #microbiota? http://t.co/FZE0q77wJj Thanks to…", "created_at"=>"2014-02-27T09:50:53Z", "user"=>"BSPGHAN", "user_name"=>"BSPGHAN", "user_profile_image"=>"http://pbs.twimg.com/profile_images/3180858543/f9ce2ec932e7b31c6a441de1221c80ec_normal.jpeg"}
• {"id"=>"438975862676156417", "text"=>"RT @StratRH: Fascinating study suggesting #obesity linked to Cesarean section. Surely must be #microbiota? http://t.co/FZE0q77wJj Thanks to…", "created_at"=>"2014-02-27T09:56:16Z", "user"=>"PaulWhiteleyPhD", "user_name"=>"Paul Whiteley", "user_profile_image"=>"http://pbs.twimg.com/profile_images/378800000344449848/35f9d576889f4cf18b0bcf1f367afa4f_normal.jpeg"}
• {"id"=>"438980194351992832", "text"=>"RT @StratRH: Fascinating study suggesting #obesity linked to Cesarean section. Surely must be #microbiota? http://t.co/FZE0q77wJj Thanks to…", "created_at"=>"2014-02-27T10:13:28Z", "user"=>"contempl_activ", "user_name"=>"Helen H", "user_profile_image"=>"http://pbs.twimg.com/profile_images/420159608096030720/L-3CtECa_normal.jpeg"}
• {"id"=>"439003442443722752", "text"=>"@bbcturkce araştırmanın linkini de koyun ki haberlere inandırıcı olsun. http://t.co/rLb0uOjPMi", "created_at"=>"2014-02-27T11:45:51Z", "user"=>"bendeburdayim", "user_name"=>"Dilan", "user_profile_image"=>"http://pbs.twimg.com/profile_images/378800000037821920/b748002a164a9427d82b416da6c2c2ed_normal.jpeg"}
• {"id"=>"439031905787207680", "text"=>"RT @StratRH: Fascinating study suggesting #obesity linked to Cesarean section. Surely must be #microbiota? http://t.co/FZE0q77wJj Thanks to…", "created_at"=>"2014-02-27T13:38:57Z", "user"=>"Jfpohl", "user_name"=>"John F. Pohl", "user_profile_image"=>"http://pbs.twimg.com/profile_images/422566001750708224/YMRuGpwS_normal.jpeg"}
• {"id"=>"439053487129628673", "text"=>"Correlational study links Birth by C-section with Future Bodyweight...causality remains to be seen. http://t.co/GelphXFgUN", "created_at"=>"2014-02-27T15:04:43Z", "user"=>"DanRyder3", "user_name"=>"Dan Ryder", "user_profile_image"=>"http://pbs.twimg.com/profile_images/378800000568515588/d250cff0cdcc438774bbb1e11e5e8ed5_normal.jpeg"}
• {"id"=>"439181923580399616", "text"=>"Cesarea, peso al nacer y obesidad http://t.co/R9QfJAI19a", "created_at"=>"2014-02-27T23:35:04Z", "user"=>"evidenciasmfyc", "user_name"=>"Miguel Angel María", "user_profile_image"=>"http://pbs.twimg.com/profile_images/430778610233122817/WaDGQrja_normal.jpeg"}
• {"id"=>"439280659064836096", "text"=>"RT @sxbegle: Cesarean babies are 26% more likely to be obese/overwt. Might relate to gut bacteria baby gets via vaginal delivery: http://t.…", "created_at"=>"2014-02-28T06:07:25Z", "user"=>"Cathyld123", "user_name"=>"Cathy Lewis-Doughert", "user_profile_image"=>"http://abs.twimg.com/sticky/default_profile_images/default_profile_3_normal.png"}
• {"id"=>"440527013841883136", "text"=>"Nacer por cesárea está asociado a mayor riesgo de sobrepeso y obesidad en vida adulta http://t.co/wUIyGUdhOh", "created_at"=>"2014-03-03T16:39:59Z", "user"=>"GaboTuitero", "user_name"=>"Gabriel León", "user_profile_image"=>"http://pbs.twimg.com/profile_images/438727522025345024/m7WdCv66_normal.jpeg"}
• {"id"=>"440527105093165056", "text"=>"RT @GaboTuitero: Nacer por cesárea está asociado a mayor riesgo de sobrepeso y obesidad en vida adulta http://t.co/wUIyGUdhOh", "created_at"=>"2014-03-03T16:40:21Z", "user"=>"dracecicastillo", "user_name"=>"Cecilia Castillo L.", "user_profile_image"=>"http://pbs.twimg.com/profile_images/378800000022168258/247c2f9cb3994e3d8eb393da2a5490b0_normal.jpeg"}
• {"id"=>"440527564415594497", "text"=>"RT @GaboTuitero: Nacer por cesárea está asociado a mayor riesgo de sobrepeso y obesidad en vida adulta http://t.co/wUIyGUdhOh", "created_at"=>"2014-03-03T16:42:10Z", "user"=>"SusanaQuezada2", "user_name"=>"Susana Quezada", "user_profile_image"=>"http://pbs.twimg.com/profile_images/433022957217394688/QuqhVqd9_normal.jpeg"}
• {"id"=>"440527731332501505", "text"=>"RT @GaboTuitero: Nacer por cesárea está asociado a mayor riesgo de sobrepeso y obesidad en vida adulta http://t.co/wUIyGUdhOh", "created_at"=>"2014-03-03T16:42:50Z", "user"=>"juanseapi", "user_name"=>"JuanseBee WerkenApi", "user_profile_image"=>"http://pbs.twimg.com/profile_images/378800000609018385/ea912e61697df72e9d44ecb04fa87bf0_normal.png"}
• {"id"=>"440529250806812672", "text"=>"RT @GaboTuitero: Nacer por cesárea está asociado a mayor riesgo de sobrepeso y obesidad en vida adulta http://t.co/wUIyGUdhOh", "created_at"=>"2014-03-03T16:48:52Z", "user"=>"BiotecUchile", "user_name"=>"Ing. Biotec. Molec.", "user_profile_image"=>"http://pbs.twimg.com/profile_images/3500394652/bed3d3846dadacb9b4430b8f624b0ac8_normal.jpeg"}
• {"id"=>"440529510627151873", "text"=>"RT @GaboTuitero: Nacer por cesárea está asociado a mayor riesgo de sobrepeso y obesidad en vida adulta http://t.co/wUIyGUdhOh", "created_at"=>"2014-03-03T16:49:54Z", "user"=>"lindiwiss", "user_name"=>"Fernanda F. R.", "user_profile_image"=>"http://pbs.twimg.com/profile_images/438663484667334656/nSD7Zx65_normal.jpeg"}
• {"id"=>"440530336682737665", "text"=>"RT @GaboTuitero: Nacer por cesárea está asociado a mayor riesgo de sobrepeso y obesidad en vida adulta http://t.co/wUIyGUdhOh", "created_at"=>"2014-03-03T16:53:11Z", "user"=>"djgeo", "user_name"=>"Geo", "user_profile_image"=>"http://pbs.twimg.com/profile_images/434217862413045760/l8IOYPue_normal.jpeg"}
• {"id"=>"440532011711598592", "text"=>"RT @GaboTuitero: Nacer por cesárea está asociado a mayor riesgo de sobrepeso y obesidad en vida adulta http://t.co/wUIyGUdhOh", "created_at"=>"2014-03-03T16:59:51Z", "user"=>"lupor84", "user_name"=>"Roberto Araneda O", "user_profile_image"=>"http://pbs.twimg.com/profile_images/420662476418473984/zjuhYtMa_normal.jpeg"}
• {"id"=>"440532691206021120", "text"=>"RT @GaboTuitero: Nacer por cesárea está asociado a mayor riesgo de sobrepeso y obesidad en vida adulta http://t.co/wUIyGUdhOh", "created_at"=>"2014-03-03T17:02:32Z", "user"=>"Sh1ken", "user_name"=>"Felipe Larenas", "user_profile_image"=>"http://pbs.twimg.com/profile_images/436901841326964736/b_Hrr6UG_normal.png"}
• {"id"=>"440570023824732160", "text"=>"PLOS: C-section babies more likely to be overweight. Maternal weight huge factor, but maybe microbiome plays role?http://t.co/Qb2q5qUnl6", "created_at"=>"2014-03-03T19:30:53Z", "user"=>"kirkwillmarth", "user_name"=>"Kirk Willmarth", "user_profile_image"=>"http://pbs.twimg.com/profile_images/2226862463/Embryo_12.5_normal.jpg"}
• {"id"=>"440713300264116224", "text"=>"Mode of Delivery and Offspring Body Mass Index, Overweight and Obesity in Adult Life: http://t.co/R20l0EMqzV #research via @PLOS", "created_at"=>"2014-03-04T05:00:13Z", "user"=>"MHTF", "user_name"=>"MHTF", "user_profile_image"=>"http://pbs.twimg.com/profile_images/3595911550/067e36a5fc30cbf57f4ba13d64c609ac_normal.jpeg"}
• {"id"=>"441152469511720960", "text"=>"Thx @MHTF: Mode of Delivery and Offspring Body Mass Index, Overweight and Obesity in Adult Life: http://t.co/kKMOjBv5YS #research via @PLOS#", "created_at"=>"2014-03-05T10:05:19Z", "user"=>"YoungEASO", "user_name"=>"YoungEASO", "user_profile_image"=>"http://pbs.twimg.com/profile_images/378800000855949777/959078fdb9df9a65d3a36ac2b755d629_normal.jpeg"}
• {"id"=>"441208117292843008", "text"=>"csection and risk of obesity in offspring. http://t.co/nv8T4hwBhs", "created_at"=>"2014-03-05T13:46:27Z", "user"=>"YourDoulaBag", "user_name"=>"Alice Turner", "user_profile_image"=>"http://pbs.twimg.com/profile_images/708738463/Logo-Gif_normal.gif"}
• {"id"=>"441238187629764608", "text"=>"PLOS ONE: Kaiserschnitt erhöht Wahrscheinlichkeit für späteres starkes Übergerwicht\nhttp://t.co/DpMwPvIMlc", "created_at"=>"2014-03-05T15:45:56Z", "user"=>"birthtimedoula", "user_name"=>"Birthtimedoula", "user_profile_image"=>"http://pbs.twimg.com/profile_images/378800000306856040/d6ba027697c14e70c4645838a2e58c9f_normal.jpeg"}
• {"id"=>"441277400047820800", "text"=>"Hey @carriemurph, did you see this? Strong association between CS &amp; overweight and obesity in adulthood http://t.co/Pb9jKwkCHx", "created_at"=>"2014-03-05T18:21:45Z", "user"=>"BrackenScott", "user_name"=>"Jen Bracken Scott", "user_profile_image"=>"http://pbs.twimg.com/profile_images/378800000779755794/50963c62e2a9f15623e70c446d3c5222_normal.jpeg"}
• {"id"=>"441619826499670016", "text"=>"Mode of Delivery and Offspring Body Mass Index, Overweight and #Obesity in Adult Life: http://t.co/w4xKGYYoVh #research via @PLOS @MHTF", "created_at"=>"2014-03-06T17:02:26Z", "user"=>"EASOobesity", "user_name"=>"EASO", "user_profile_image"=>"http://pbs.twimg.com/profile_images/378800000094878313/0a1165f456950641ae2366d59f52dcda_normal.jpeg"}
• {"id"=>"441619840936464385", "text"=>"RT @EASOobesity: Mode of Delivery and Offspring Body Mass Index, Overweight and #Obesity in Adult Life: http://t.co/w4xKGYYoVh #research vi…", "created_at"=>"2014-03-06T17:02:29Z", "user"=>"WeightLossBio", "user_name"=>"#WeightLoss ", "user_profile_image"=>"http://pbs.twimg.com/profile_images/378800000701467546/b37a6ed5e8134b19768ab6513023108d_normal.jpeg"}
• {"id"=>"441932563985096704", "text"=>"Mode of Delivery and Offspring Body Mass Index, Overweight &amp; Obesity in Adult Life: A Review and Meta-Analysis http://t.co/RFree5fxLO", "created_at"=>"2014-03-07T13:45:08Z", "user"=>"foodforsportza", "user_name"=>"Adrian Penzhorn", "user_profile_image"=>"http://pbs.twimg.com/profile_images/378800000143457430/3f4263a40ddbc5ff521fd53dc690bbc2_normal.jpeg"}
• {"id"=>"442042596865867776", "text"=>"Meta-analysis supports association between c-section delivery and offspring obesity\nhttp://t.co/fUK5JBi1Kl", "created_at"=>"2014-03-07T21:02:22Z", "user"=>"whsource", "user_name"=>"Stephan Guyenet, PhD", "user_profile_image"=>"http://pbs.twimg.com/profile_images/2683888668/6ae8d6cda7d7f091f7ffd987dbadaa72_normal.jpeg"}
• {"id"=>"442043267186966528", "text"=>"RT @whsource: Meta-analysis supports association between c-section delivery and offspring obesity\nhttp://t.co/fUK5JBi1Kl", "created_at"=>"2014-03-07T21:05:02Z", "user"=>"Firefly_fan", "user_name"=>"Marc Casañas Escarré", "user_profile_image"=>"http://pbs.twimg.com/profile_images/412574483426197504/mVT2h-Np_normal.png"}
• {"id"=>"442050917559328769", "text"=>"RT @whsource: Meta-analysis supports association between c-section delivery and offspring obesity\nhttp://t.co/fUK5JBi1Kl", "created_at"=>"2014-03-07T21:35:26Z", "user"=>"drjessedavis", "user_name"=>"Jesse Davis", "user_profile_image"=>"http://pbs.twimg.com/profile_images/699122735/photo_normal.jpg"}
• {"id"=>"442112503649435648", "text"=>"RT @whsource: Meta-analysis supports association between c-section delivery and offspring obesity\nhttp://t.co/fUK5JBi1Kl", "created_at"=>"2014-03-08T01:40:09Z", "user"=>"jcsouto", "user_name"=>"Jose Carlos Souto", "user_profile_image"=>"http://pbs.twimg.com/profile_images/263413017/Foto_Jose_Souto_normal.jpg"}
• {"id"=>"442282690021060608", "text"=>"RT @whsource: Meta-analysis supports association between c-section delivery and offspring obesity\nhttp://t.co/fUK5JBi1Kl", "created_at"=>"2014-03-08T12:56:25Z", "user"=>"alexmyers83", "user_name"=>"Alex Myers", "user_profile_image"=>"http://pbs.twimg.com/profile_images/423419453867438080/u-v3D8Gp_normal.jpeg"}
• {"id"=>"442390608523841536", "text"=>"Meta-analysis strengthens link between C-section delivery and obesity in offspring\nhttp://t.co/fUK5JBi1Kl", "created_at"=>"2014-03-08T20:05:14Z", "user"=>"whsource", "user_name"=>"Stephan Guyenet, PhD", "user_profile_image"=>"http://pbs.twimg.com/profile_images/2683888668/6ae8d6cda7d7f091f7ffd987dbadaa72_normal.jpeg"}
• {"id"=>"442391932225191936", "text"=>"RT @whsource: Meta-analysis strengthens link between C-section delivery and obesity in offspring\nhttp://t.co/fUK5JBi1Kl", "created_at"=>"2014-03-08T20:10:30Z", "user"=>"nacho_zizou", "user_name"=>"Nacho Castro Fdez", "user_profile_image"=>"http://pbs.twimg.com/profile_images/378800000819480789/b784dee52c37b64e48afd2e8a4f80d5b_normal.jpeg"}
• {"id"=>"442395548096929792", "text"=>"RT @whsource: Meta-analysis strengthens link between C-section delivery and obesity in offspring\nhttp://t.co/fUK5JBi1Kl", "created_at"=>"2014-03-08T20:24:52Z", "user"=>"OscarPicazo", "user_name"=>"Óscar Picazo", "user_profile_image"=>"http://pbs.twimg.com/profile_images/378800000180018020/0680ab0ed45097046c3ec6a8460fed85_normal.jpeg"}
• {"id"=>"442397415845269504", "text"=>"RT @whsource: Meta-analysis strengthens link between C-section delivery and obesity in offspring\nhttp://t.co/fUK5JBi1Kl", "created_at"=>"2014-03-08T20:32:17Z", "user"=>"birthandfitness", "user_name"=>"Linzi Stahlecker", "user_profile_image"=>"http://pbs.twimg.com/profile_images/433301856521945088/1P9BK23h_normal.jpeg"}
• {"id"=>"442401281315848192", "text"=>"RT @whsource: Meta-analysis strengthens link between C-section delivery and obesity in offspring\nhttp://t.co/fUK5JBi1Kl", "created_at"=>"2014-03-08T20:47:39Z", "user"=>"VegetableManDan", "user_name"=>"Daniel J. Schultz", "user_profile_image"=>"http://pbs.twimg.com/profile_images/439209426835103746/jSDtFK2d_normal.jpeg"}
• {"id"=>"442434297753243648", "text"=>"RT @whsource: Meta-analysis strengthens link between C-section delivery and obesity in offspring\nhttp://t.co/fUK5JBi1Kl", "created_at"=>"2014-03-08T22:58:51Z", "user"=>"jcsouto", "user_name"=>"Jose Carlos Souto", "user_profile_image"=>"http://pbs.twimg.com/profile_images/263413017/Foto_Jose_Souto_normal.jpg"}
• {"id"=>"442510811433811968", "text"=>"RT @whsource: Meta-analysis supports association between c-section delivery and offspring obesity\nhttp://t.co/fUK5JBi1Kl", "created_at"=>"2014-03-09T04:02:53Z", "user"=>"DoctorEndocrine", "user_name"=>"Elena Christofides", "user_profile_image"=>"http://pbs.twimg.com/profile_images/3043205951/5eefe544e0aa9d706f69c5e7a52e5dc8_normal.jpeg"}
• {"id"=>"442550880135819264", "text"=>"Meta-analysis: C-section delivery↑risk of obesity in offspring\nhttp://t.co/JzJtrkBzoQ Differences in microbiome may explain ht @whsource", "created_at"=>"2014-03-09T06:42:06Z", "user"=>"pronutritionist", "user_name"=>"Reijo Laatikainen", "user_profile_image"=>"http://pbs.twimg.com/profile_images/3441219846/787933e7eff4e3de36a9c49721f3bf3d_normal.jpeg"}
• {"id"=>"442917104941953024", "text"=>"Mode of Delivery and Offspring BMI, Overweight and Obesity in Adult Life: A Systematic Review and Meta-Analysis http://t.co/RFree5fxLO", "created_at"=>"2014-03-10T06:57:21Z", "user"=>"foodforsportza", "user_name"=>"Adrian Penzhorn R.D.", "user_profile_image"=>"http://pbs.twimg.com/profile_images/378800000143457430/3f4263a40ddbc5ff521fd53dc690bbc2_normal.jpeg"}
• {"id"=>"442927043140153344", "text"=>"Interesting review! “@foodforsportza: Mode of Delivery and Offspring BMI, Overweight and Obesity in Adult Life http://t.co/Jzmrfn2TQ0”", "created_at"=>"2014-03-10T07:36:50Z", "user"=>"natmat", "user_name"=>"Nathalie Mat", "user_profile_image"=>"http://pbs.twimg.com/profile_images/378800000853790520/ec99a3b8fb09c183a02d1adad7a5465a_normal.png"}
• {"id"=>"442928700992929792", "text"=>"RT @natmat: Interesting review! “@foodforsportza: Mode of Delivery and Offspring BMI, Overweight and Obesity in Adult Life http://t.co/Jzmr…", "created_at"=>"2014-03-10T07:43:26Z", "user"=>"foodforsportza", "user_name"=>"Adrian Penzhorn R.D.", "user_profile_image"=>"http://pbs.twimg.com/profile_images/378800000143457430/3f4263a40ddbc5ff521fd53dc690bbc2_normal.jpeg"}
• {"id"=>"443169398262882304", "text"=>"Meta-analysis: babies delivered via C-section more likely to be obese later in life - confounding by maternal weight? http://t.co/SnlyeJb6xr", "created_at"=>"2014-03-10T23:39:52Z", "user"=>"DrMollyWaring", "user_name"=>"Molly Waring", "user_profile_image"=>"http://pbs.twimg.com/profile_images/417473783239159808/QU3o3INh_normal.jpeg"}
• {"id"=>"443838866148294656", "text"=>"a potential association between C-sections and obesity?\nhttp://t.co/d5hrrHwM3B", "created_at"=>"2014-03-12T20:00:06Z", "user"=>"TuftsGlobHealth", "user_name"=>"Tufts Global Health", "user_profile_image"=>"http://pbs.twimg.com/profile_images/378800000567982535/a6864da58dfc32935ce3843c91733aa9_normal.png"}
• {"id"=>"445107266539511808", "text"=>"@JuanGrvas @albertinquiet encima tengo que leer este estudio:\nhttp://t.co/GNBKrkF2on\n\nEn el abstract dicen que ven correlación.", "created_at"=>"2014-03-16T08:00:16Z", "user"=>"Firefly_fan", "user_name"=>"Marc Casañas Escarré", "user_profile_image"=>"http://pbs.twimg.com/profile_images/412574483426197504/mVT2h-Np_normal.png"}
• {"id"=>"488801319843414016", "text"=>"Mode of Delivery and Offspring Body Mass Index, Overweight and Obesity in Adult Life: A Systematic Review and... http://t.co/TEncu6vYfb", "created_at"=>"2014-07-14T21:44:50Z", "user"=>"KentBottles", "user_name"=>"KentBottles", "user_profile_image"=>"http://pbs.twimg.com/profile_images/855175841/Kent_Photo_1712-1_normal.jpg"}
• {"id"=>"488801560407719936", "text"=>"RT @KentBottles: Mode of Delivery and Offspring Body Mass Index, Overweight and Obesity in Adult Life: A Systematic Review and... http://t.…", "created_at"=>"2014-07-14T21:45:48Z", "user"=>"TimAllenMDJD", "user_name"=>"Timothy Craig Allen", "user_profile_image"=>"http://pbs.twimg.com/profile_images/1231087034/Allen_image_1a_normal.jpg"}
• {"id"=>"512307929710882820", "text"=>"Babies delivered vaginally were 26% more likely to be overweight as adults than those born by cesarean section http://t.co/g4lTELPelM", "created_at"=>"2014-09-17T18:31:43Z", "user"=>"gineblog", "user_name"=>"Gineblog", "user_profile_image"=>"http://pbs.twimg.com/profile_images/2711872512/18892054712cc6f96fcf898eff9462f5_normal.jpeg"}
• {"id"=>"512322893951537152", "text"=>"Strong association between #Cesarean section and increased offspring BMI, #overweight and #obesity in adulthood. http://t.co/g4lTELPelM", "created_at"=>"2014-09-17T19:31:11Z", "user"=>"gineblog", "user_name"=>"Gineblog", "user_profile_image"=>"http://pbs.twimg.com/profile_images/2711872512/18892054712cc6f96fcf898eff9462f5_normal.jpeg"}
• {"id"=>"512329789391527936", "text"=>"Intensa asociación entre nacer por #Cesarea y aumento del peso de neonato, #sobrepeso y #obesidad en vida adulta. http://t.co/g4lTELPelM …", "created_at"=>"2014-09-17T19:58:35Z", "user"=>"gineblog", "user_name"=>"Gineblog", "user_profile_image"=>"http://pbs.twimg.com/profile_images/2711872512/18892054712cc6f96fcf898eff9462f5_normal.jpeg"}
• {"id"=>"543735259888906240", "text"=>"Mode of Delivery and Offspring Body Mass Index, Overweight and Obesity in Adult Life: A Systematic Review http://t.co/zI5HHfyPhv", "created_at"=>"2014-12-13T11:52:42Z", "user"=>"AGomez72803809", "user_name"=>"A, Gomez", "user_profile_image"=>"http://pbs.twimg.com/profile_images/424229817597181952/PcgNpdn0_normal.jpeg"}
• {"id"=>"543735962829078528", "text"=>"El Tipo de parto e índice de masa corporal, sobrepeso y obesidad en la vida adulta: una revisión sistemática http://t.co/zI5HHfyPhv", "created_at"=>"2014-12-13T11:55:30Z", "user"=>"AGomez72803809", "user_name"=>"A, Gomez", "user_profile_image"=>"http://pbs.twimg.com/profile_images/424229817597181952/PcgNpdn0_normal.jpeg"}
• {"id"=>"613258385627201536", "text"=>"@chupilili meta-análisis: los niños que nacen por cesárea tienen mayor probabilidad de sobrepeso en la infancia http://t.co/Akgdtvli0n", "created_at"=>"2015-06-23T08:12:47Z", "user"=>"nutri_rivers", "user_name"=>"Carlos Ríos", "user_profile_image"=>"http://pbs.twimg.com/profile_images/2494080430/IMG-20120812-WA000_normal.png"}

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Figshare

• {"files"=>["https://ndownloader.figshare.com/files/1399360"], "description"=>"<p>The relevant number of papers at each point is given.</p>", "links"=>[], "tags"=>["Population biology", "epidemiology", "Social epidemiology", "Clinical research design", "meta-analyses", "Systematic reviews", "nutrition", "obesity", "Obstetrics and gynecology", "Labor and delivery", "pediatrics", "Neonatology"], "article_id"=>945251, "categories"=>["Biological Sciences", "Medicine"], "users"=>["Karthik Darmasseelane", "Matthew J. Hyde", "Shalini Santhakumaran", "Chris Gale", "Neena Modi"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0087896.g001", "stats"=>{"downloads"=>1, "page_views"=>9, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Flow_chart_of_the_search_strategy_used_in_the_review_/945251", "title"=>"Flow chart of the search strategy used in the review.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2014-02-26 03:38:18"}
• {"files"=>["https://ndownloader.figshare.com/files/1399364"], "description"=>"<p>Forest Plot showing the pooled gender, unadjusted mean BMI difference in adult offspring by mode of delivery.</p>", "links"=>[], "tags"=>["Population biology", "epidemiology", "Social epidemiology", "Clinical research design", "meta-analyses", "Systematic reviews", "nutrition", "obesity", "Obstetrics and gynecology", "Labor and delivery", "pediatrics", "Neonatology", "cs", "higher"], "article_id"=>945253, "categories"=>["Biological Sciences", "Medicine"], "users"=>["Karthik Darmasseelane", "Matthew J. Hyde", "Shalini Santhakumaran", "Chris Gale", "Neena Modi"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0087896.g002", "stats"=>{"downloads"=>4, "page_views"=>10, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Offspring_born_by_CS_have_higher_BMI_/945253", "title"=>"Offspring born by CS have higher BMI.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2014-02-26 03:38:18"}
• {"files"=>["https://ndownloader.figshare.com/files/1399365"], "description"=>"<p>Forest Plot showing the pooled gender, unadjusted OR for incidence of overweight in adult offspring, by mode of delivery.</p>", "links"=>[], "tags"=>["Population biology", "epidemiology", "Social epidemiology", "Clinical research design", "meta-analyses", "Systematic reviews", "nutrition", "obesity", "Obstetrics and gynecology", "Labor and delivery", "pediatrics", "Neonatology", "cs", "higher", "incidence"], "article_id"=>945254, "categories"=>["Biological Sciences", "Medicine"], "users"=>["Karthik Darmasseelane", "Matthew J. Hyde", "Shalini Santhakumaran", "Chris Gale", "Neena Modi"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0087896.g003", "stats"=>{"downloads"=>2, "page_views"=>10, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Offspring_born_by_CS_have_higher_incidence_of_overweight_/945254", "title"=>"Offspring born by CS have higher incidence of overweight.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2014-02-26 03:38:18"}
• {"files"=>["https://ndownloader.figshare.com/files/1399366"], "description"=>"<p>Forest Plot showing the pooled gender, unadjusted OR for incidence of obesity in adult offspring by mode of delivery.</p>", "links"=>[], "tags"=>["Population biology", "epidemiology", "Social epidemiology", "Clinical research design", "meta-analyses", "Systematic reviews", "nutrition", "obesity", "Obstetrics and gynecology", "Labor and delivery", "pediatrics", "Neonatology", "cs", "higher", "incidence"], "article_id"=>945255, "categories"=>["Biological Sciences", "Medicine"], "users"=>["Karthik Darmasseelane", "Matthew J. Hyde", "Shalini Santhakumaran", "Chris Gale", "Neena Modi"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0087896.g004", "stats"=>{"downloads"=>5, "page_views"=>9, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Offspring_born_by_CS_have_higher_incidence_of_obesity_/945255", "title"=>"Offspring born by CS have higher incidence of obesity.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2014-02-26 03:38:18"}
• {"files"=>["https://ndownloader.figshare.com/files/1399367"], "description"=>"<p><b>PC:</b> Prospective Cohort Study; <b>PBC:</b> Population-Based Cohort Study; <b>RC:</b> Retrospective Cohort Study; <b>NOS:</b> Modified Newcastle-Ottawa Scale Score; <b>M:</b> Male; <b>F:</b> Female; <b>VD:</b> Vaginal Delivery; <b>CS:</b> Caesarean Section; <b>IL-CS:</b> Emergency/In-Labour Caesarean Section; <b>PL-CS:</b> Elective/Pre-Labour Caesarean Section; <b>MoD:</b> Mode of Delivery; <b>BMI:</b> Body Mass Index; <b>SES:</b> Socio-Economic Status; <b>ACONF:</b> Aberdeen Children of the 1950s; <b>VLBWA:</b> Very Low Birth Weight Adults</p>", "links"=>[], "tags"=>["Population biology", "epidemiology", "Social epidemiology", "Clinical research design", "meta-analyses", "Systematic reviews", "nutrition", "obesity", "Obstetrics and gynecology", "Labor and delivery", "pediatrics", "Neonatology", "included", "meta-analysis", "examining", "offspring", "bmi"], "article_id"=>945256, "categories"=>["Biological Sciences", "Medicine"], "users"=>["Karthik Darmasseelane", "Matthew J. Hyde", "Shalini Santhakumaran", "Chris Gale", "Neena Modi"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0087896.t001", "stats"=>{"downloads"=>1, "page_views"=>12, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Studies_included_in_this_meta_analysis_examining_the_association_between_mode_of_delivery_and_offspring_BMI_in_adulthood_/945256", "title"=>"Studies included in this meta-analysis examining the association between mode of delivery and offspring BMI in adulthood.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2014-02-26 03:38:18"}
• {"files"=>["https://ndownloader.figshare.com/files/1399368"], "description"=>"<p>Summary of all meta-analysis results.</p>", "links"=>[], "tags"=>["Population biology", "epidemiology", "Social epidemiology", "Clinical research design", "meta-analyses", "Systematic reviews", "nutrition", "obesity", "Obstetrics and gynecology", "Labor and delivery", "pediatrics", "Neonatology", "meta-analysis"], "article_id"=>945257, "categories"=>["Biological Sciences", "Medicine"], "users"=>["Karthik Darmasseelane", "Matthew J. Hyde", "Shalini Santhakumaran", "Chris Gale", "Neena Modi"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0087896.t002", "stats"=>{"downloads"=>1, "page_views"=>13, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Summary_of_all_meta_analysis_results_/945257", "title"=>"Summary of all meta-analysis results.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2014-02-26 03:38:18"}
• {"files"=>["https://ndownloader.figshare.com/files/1399370", "https://ndownloader.figshare.com/files/1399371", "https://ndownloader.figshare.com/files/1399372", "https://ndownloader.figshare.com/files/1399373", "https://ndownloader.figshare.com/files/1399374", "https://ndownloader.figshare.com/files/1399375", "https://ndownloader.figshare.com/files/1399376", "https://ndownloader.figshare.com/files/1399377", "https://ndownloader.figshare.com/files/1399378", "https://ndownloader.figshare.com/files/1399379", "https://ndownloader.figshare.com/files/1399380", "https://ndownloader.figshare.com/files/1399381", "https://ndownloader.figshare.com/files/1399382", "https://ndownloader.figshare.com/files/1399383"], "description"=>"<div><p>Background</p><p>It has been suggested that mode of delivery, a potentially powerful influence upon long-term health, may affect later life body mass index (BMI). We conducted a systematic review and meta-analysis of the effect of Caesarean section (CS) and vaginal delivery (VD) on offspring BMI, overweight (BMI>25) and obesity (BMI>30) in adulthood. Secondary outcomes were subgroup analyses by gender and type of CS (in-labour/emergency, pre-labour/elective).</p><p>Methods</p><p>Using a predefined search strategy, Pubmed, Google Scholar and Web of Science were searched for any article published before 31^st March 2012, along with references of any studies deemed relevant. Studies were selected if they reported birth characteristics and long-term offspring follow-up into adulthood. Aggregate data from relevant studies were extracted onto a pre-piloted data table. A random-effects meta-analysis was carried out in RevMan5. Results are illustrated using forest plots and funnel plots, and presented as mean differences or odds ratios (OR) and 95% confidence intervals.</p><p>Results</p><p>Thirty-five studies were identified through the search, and 15 studies with a combined population of 163,753 were suitable for inclusion in the meta-analysis. Comparing all CS to VD in pooled-gender unadjusted analyses, mean BMI difference was 0·44 kg·m^-2 (0·17, 0·72; <i>p</i> = 0·002), OR for incidence of overweight was 1·26 (1·16, 1·38; <i>p</i><0·00001) and OR for incidence of obesity was 1·22 (1·05, 1·42; <i>p = </i>0·01). Heterogeneity was low in all primary analyses. Similar results were found in gender-specific subgroup analyses. Subgroup analyses comparing type of CS to VD showed no significant impact on any outcome.</p><p>Conclusions</p><p>There is a strong association between CS and increased offspring BMI, overweight and obesity in adulthood. Given the rising CS rate worldwide there is a need to determine whether this is causal, or reflective of confounding influences.</p><p>Systematic review registration</p><p>An <i>a priori</i> protocol was registered on PROSPERO (registration number: CRD42011001851)</p></div>", "links"=>[], "tags"=>["Population biology", "epidemiology", "Social epidemiology", "Clinical research design", "meta-analyses", "Systematic reviews", "nutrition", "obesity", "Obstetrics and gynecology", "Labor and delivery", "pediatrics", "Neonatology", "offspring", "overweight", "systematic"], "article_id"=>945259, "categories"=>["Biological Sciences", "Medicine"], "users"=>["Karthik Darmasseelane", "Matthew J. Hyde", "Shalini Santhakumaran", "Chris Gale", "Neena Modi"], "doi"=>["https://dx.doi.org/10.1371/journal.pone.0087896.s001", "https://dx.doi.org/10.1371/journal.pone.0087896.s002", "https://dx.doi.org/10.1371/journal.pone.0087896.s003", "https://dx.doi.org/10.1371/journal.pone.0087896.s004", "https://dx.doi.org/10.1371/journal.pone.0087896.s005", "https://dx.doi.org/10.1371/journal.pone.0087896.s006", "https://dx.doi.org/10.1371/journal.pone.0087896.s007", "https://dx.doi.org/10.1371/journal.pone.0087896.s008", "https://dx.doi.org/10.1371/journal.pone.0087896.s009", "https://dx.doi.org/10.1371/journal.pone.0087896.s010", "https://dx.doi.org/10.1371/journal.pone.0087896.s011", "https://dx.doi.org/10.1371/journal.pone.0087896.s012", "https://dx.doi.org/10.1371/journal.pone.0087896.s013", "https://dx.doi.org/10.1371/journal.pone.0087896.s014"], "stats"=>{"downloads"=>29, "page_views"=>15, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Mode_of_Delivery_and_Offspring_Body_Mass_Index_Overweight_and_Obesity_in_Adult_Life_A_Systematic_Review_and_Meta_Analysis_/945259", "title"=>"Mode of Delivery and Offspring Body Mass Index, Overweight and Obesity in Adult Life: A Systematic Review and Meta-Analysis", "pos_in_sequence"=>0, "defined_type"=>4, "published_date"=>"2014-02-26 03:38:18"}

PMC Usage Stats | Further Information

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Relative Metric

{"start_date"=>"2014-01-01T00:00:00Z", "end_date"=>"2014-12-31T00:00:00Z", "subject_areas"=>[{"subject_area"=>"/Medicine and health sciences/Physiology", "average_usage"=>[278]}, {"subject_area"=>"/People and places", "average_usage"=>[302]}, {"subject_area"=>"/People and places/Population groupings", "average_usage"=>[300]}, {"subject_area"=>"/Physical sciences/Mathematics", "average_usage"=>[286]}]}

F1000Prime