# Relationship Between Type of Delivery and Growth Trajectory in the First Year of Life: The Araraquara Cohort Study

## TL;DR

This study found no link between cesarean delivery and infant growth rates in the first year of life, with growth more influenced by maternal and infant characteristics.

## Contribution

The study provides new evidence that the type of delivery does not affect infant growth trajectory in the first year of life.

## Key findings

- Cesarean delivery was not associated with weight or length gain velocity in infants.
- Infant growth was more influenced by maternal education, feeding practices, and health conditions than delivery type.
- Formula-fed infants and those with lower birth weight showed higher weight gain velocity.

## Abstract

The relationship between cesarean delivery and infant growth is controversial. Therefore, the aim of this study was to evaluate the association between the type of delivery and the growth trajectory of Brazilian infants in the first year of life.

This was a prospective cohort study conducted between 2016 and 2021 as part of the Araraquara Cohort Study that assessed quarterly anthropometry of 719 and 667 infants to evaluate, respectively, the effects of type of delivery on weight gain velocity (WGV) and length gain velocity (LGV) using generalized estimating equations.

The type of delivery was not associated with WGV or LGV in the first year of life. Higher mean WGV was observed among infants born to mothers with higher education, male infants, formula‐fed infants, and those with the lowest birth weight, while infants with diarrhea had lower mean WGV. Higher mean LGV was found among formula‐fed infants and infants born to taller mothers, while infants with the highest length at birth had lower LGV.

The factors that explain WGV and LGV in this population are more closely related to maternal characteristics such as height and educational attainment, birth characteristics, feeding behavior, and morbidity than to the type of delivery.

Graph 1 Type of delivery and weight gain velocity (WGV) in the first year of life. Exposure = Cesarean delivery. Outcome = WGV, Confounders = sex, birth weight, maternal BMI, maternal education and per capita income; Variables associated with the exposure or with the outcome = breastfeeding in the first hour, marital status, breastfeeding, hospitalization, diarrhea, respiratory infection and anemia. Type of delivery and length gain velocity (LGV) in the first year of life. Exposure = Cesarean delivery. Outcome = LGV, Confounders = sex, length at birth, maternal height, maternal education and per capita income); Variables associated with the exposure or with the outcome = breastfeeding in the first hour, marital status, breastfeeding, hospitalization, diarrhea, respiratory infection and anemia.