Zhou YB, et al. - A Chinese birth cohort, including 1467 children followed up at the age of 4–7 years, was used in this study to examine the link of elective cesarean delivery (ElCD) with metabolic syndrome (MetS) and its components. Of 1467 cases, 737 children were delivered by ElCD and 730 by spontaneous vaginal delivery. The definition of MetS used in this analysis was the presence of ≥3 components: central obesity, hypertriglyceridemia, low high-density lipoprotein, high fasting glucose, and hypertension. In early to middle childhood, no link between ElCD and MetS was evident. However, an association of ElCD with the components of MetS, including central obesity and hypertension, as well as various continuous indices was found in this study.