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Comment & Response
June 2017

Obesity and Cesarean Section—Reply

Author Affiliations
  • 1Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
  • 2Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
  • 3Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
JAMA Pediatr. 2017;171(6):598-599. doi:10.1001/jamapediatrics.2017.0391

In Reply We read with interest the letter by Uzoigwe and colleagues regarding our article reporting an association between birth by cesarean delivery and offspring risk of obesity.1 The authors of the letter argue that the association reported in our study could be attributed to residual confounding by interpregnancy interval. We disagree. Uzoigwe and colleagues are correct in pointing out that (1) interpregnancy interval is longer among women who deliver by cesarean than among women who deliver vaginally, (2) there is literature suggesting that a shorter interpregnancy birth interval is related to a lower risk of offspring obesity, and (3) the combination of these 2 facts opens the possibility of unaccounted confounding.

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