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We conducted a systematic review and meta\u2010analysis to summarize the available evidence and to explore study characteristics as sources of heterogeneity. A search of <jats:styled-content style=\"fixed-case\">M<\/jats:styled-content>edline, <jats:styled-content style=\"fixed-case\">EMBASE<\/jats:styled-content>, and <jats:styled-content style=\"fixed-case\">W<\/jats:styled-content>eb of <jats:styled-content style=\"fixed-case\">S<\/jats:styled-content>cience identified 28 studies. Random effects meta\u2010analysis was used to calculate pooled risk ratios (<jats:styled-content style=\"fixed-case\">RR<\/jats:styled-content>) with 95% confidence intervals (<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>). Caesarean section had a <jats:styled-content style=\"fixed-case\">RR<\/jats:styled-content> of 1.34 (<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 1.18\u20131.51) for obesity in the child compared with vaginal birth. The <jats:styled-content style=\"fixed-case\">RR<\/jats:styled-content> was lower for studies that adjusted for maternal pre\u2010pregnancy weight than for studies that did not (1.29, <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 1.16\u20131.44 vs. 1.55, <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 1.11\u20132.17). Studies that examined multiple early life factors reported lower <jats:styled-content style=\"fixed-case\">RRs<\/jats:styled-content> than studies that specifically examined caesarean section (1.39, <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 1.23\u20131.57 vs. 1.23, <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 0.97\u20131.56). Effect estimates did not vary by child's age at obesity assessment, study design or country income. Children born by caesarean section are at higher risk of developing obesity in childhood. Findings are limited by a moderate heterogeneity among studies and the potential for residual confounding and publication bias.<\/jats:p>","DOI":"10.1111\/obr.12267","type":"journal-article","created":{"date-parts":[[2015,3,5]],"date-time":"2015-03-05T13:33:19Z","timestamp":1425562399000},"page":"295-303","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":222,"title":["Association between caesarean section and childhood obesity: a systematic review and meta\u2010analysis"],"prefix":"10.1111","volume":"16","author":[{"given":"S.","family":"Kuhle","sequence":"first","affiliation":[{"name":"Perinatal Epidemiology Research Unit Departments of Obstetrics and Gynaecology and Pediatrics Dalhousie University  Halifax NS Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"O. 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