The Prevalence of Metabolic Syndrome After Cesarean and Natural Delivery in Southwest Iran, 2021 - 2022

Background: The prevalence of abdominal obesity appears to vary depending on the mode of delivery. Abdominal obesity is the most common manifestation of metabolic syndrome and plays a significant role in diagnosing metabolic disorders. Objectives: This study aimed to determine whether the mode of childbirth is associated with metabolic syndrome (MetS). Methods: A total of 350 women who had either an elective cesarean section (CS) or natural vaginal delivery (NVD) at least three years ago were included in this cross-sectional study. The sample was recruited from the integrated health system (Sib) affiliated with Ilam University of Medical Sciences in southwest Iran, 2020 - 2021, using cluster randomization. Metabolic syndrome was assessed according to the 2005 revised NCEP ATP III criteria. Descriptive data were presented as means (standard deviations, SD) or frequencies (%). A t-test was used for comparison between groups, and logistic regression analysis was employed to estimate odds ratios (ORs). Results: Metabolic syndrome was found in 18.29% of women in the NVD group and 30.29% in the elective CS group. Multivariate logistic analysis revealed that breastfeeding duration (P < 0.001) and NVD (P = 0.04) were significantly associated with a decreased likelihood of MetS among mothers. Each additional month of breastfeeding was shown to reduce the likelihood of MetS by 30%. The results also demonstrated that NVD had a protective effect against MetS (Adjusted Odds Ratio (OR): 0.57, 95% CI: 0.34 - 0.97, P = 0.04) after adjusting for age and breastfeeding duration. Conclusions: Women with a history of CS were found to have a higher prevalence of MetS than those in the NVD group. This suggests that the mode of delivery may play a role in the development of MetS after childbirth. Therefore, obstetricians and midwives should consider the potential risk of disorders such as MetS when deciding on elective cesarean sections.