The long-term effects of birth by caesarean section: the case for a randomised controlled trial

Early Hum Dev. 2012 Dec;88(12):943-9. doi: 10.1016/j.earlhumdev.2012.09.006. Epub 2012 Oct 1.


Birth by caesarean section is rising rapidly around the world and is associated with a range of adverse short and long-term outcomes in offspring. The latter include features of the metabolic syndrome, type-1 diabetes, and asthma. Though there are several plausible candidate biological mechanisms, evidence of a causal relationship between mode of delivery and long-term outcomes remains lacking. Here we review the evidence to date, and examine ways in which future studies might advance understanding. We conclude that a randomised controlled trial of mode of delivery for the healthy term, cephalic pregnancy, is neither unethical nor unfeasible and should be seriously considered as the optimum means of addressing a question of great relevance to public health.

Publication types

  • Review

MeSH terms

  • Asthma / etiology
  • Cesarean Section / adverse effects*
  • Diabetes Mellitus, Type 1 / etiology
  • Female
  • Humans
  • Metabolic Syndrome / etiology
  • Pregnancy
  • Randomized Controlled Trials as Topic
  • Time