Elective cesarean delivery at term and the long-term risk for endocrine and metabolic morbidity of the offspring

R. Moshkovsky, T. Wainstock, E. Sheiner, D. Landau, A. Walfisch

Research output: Contribution to journalArticlepeer-review

2 Scopus citations


Other than obesity, no definitive insights have been gained regarding the apparent association between mode of delivery and long-term endocrine and metabolic outcomes in the offspring. We aimed to determine whether elective cesarean delivery (CD) impacts on long-term endocrine and metabolic morbidity of the offspring. A population-based cohort analysis was performed including all singleton-term deliveries occurring between 1991 and 2014 at a single tertiary medical center. A comparison was performed between children delivered via a non-emergent CD and those delivered vaginally (VD). Hospitalizations of the offspring up to the age of 18 years involving endocrine morbidity were evaluated. A Kaplan-Meier survival curve was used to compare cumulative morbidity incidence. Cox and a Weibull regression models were used to control for confounders. During the study period 131,880 term deliveries met the inclusion criteria; 8.9% were elective non-urgent CDs (n=11,768) and 91.1% (n=120,112) were VDs. The survival curve demonstrated a significantly higher cumulative incidence of endo-metabolic morbidity in offspring born via CD (P=0.010). In the regression models, adjusted for maternal obesity, CD was not noted as an independent risk factor for long-term pediatric endocrine and metabolic morbidity of the offspring while maternal obesity emerged as a strong predictor. We therefore conclude that CD per-se does not appear to increase the risk for long-term pediatric endo-metabolic morbidity of the offspring.

Original languageEnglish
Pages (from-to)429-435
Number of pages7
JournalJournal of Developmental Origins of Health and Disease
Issue number4
StatePublished - 1 Aug 2019


  • cesarean delivery
  • endocrine
  • follow-up
  • morbidity
  • pediatric morbidity

ASJC Scopus subject areas

  • Medicine (miscellaneous)


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