剖宫产与年轻成年人的代谢风险因素：一项巴西出生队列研究。
Cesarean delivery and metabolic risk factors in young adults: a Brazilian birth cohort study.
作者信息
Bernardi Juliana Rombaldi, Pinheiro Tanara Vogel, Mueller Noel Theodore, Goldani Helena Ayako Sueno, Gutierrez Manoel Romeu Pereira, Bettiol Heloisa, Moura da Silva Antônio Augusto, Barbieri Marco Antônio, Goldani Marcelo Zubaran
机构信息
Biological and Health Sciences Center, University of Caxias do Sul, Caxias do Sul, Brazil; Department of Pediatrics, Porto Alegre Clinical Hospital, Faculty of Medicine, University of Rio Grande do Sul, Porto Alegre, Brazil;
Department of Pediatrics, Porto Alegre Clinical Hospital, Faculty of Medicine, University of Rio Grande do Sul, Porto Alegre, Brazil;
出版信息
Am J Clin Nutr. 2015 Aug;102(2):295-301. doi: 10.3945/ajcn.114.105205. Epub 2015 Jun 17.
BACKGROUND
Cesarean delivery (CD) perturbs the assembly of the neonatal gut microbiome and has been associated with child and adult obesity. However, it is still unknown whether CD is associated with metabolic risk factors in young adults.
OBJECTIVE
We investigated the association of CD and metabolic risk factors in young adults in a cohort study who were 23-25 y of age at follow-up.
DESIGN
We used data from a cohort study in Ribeirão Preto, Brazil. Baseline data on 6827 singleton pregnancies were collected in 1978-1979, and a sample of 2063 subjects were followed up 23-25 y later (2002-2004). Information on the type of delivery, birth weight, maternal age, parity, maternal schooling, and maternal smoking was obtained after birth. Anthropometric data, biochemical measurements, and information on participant schooling and smoking history were collected at 23-25 y of age. A linear regression was performed to assess the association between CD and biochemical measurements in early adulthood, controlling for a minimum set of confounders that were identified in a directed acyclic graph.
RESULTS
The mean ± SD age of the subjects was 23.9 ± 0.71 y, and 51.8% of the sample were women. The CD rate was 32.0% and was more common in older (P < 0.001) and more educated mothers (P < 0.001). Compared with vaginal delivery, CD was associated with higher body mass index (BMI) after multivariable adjustment (P < 0.001) but not with glucose, homeostasis model assessment of insulin resistance, the quantitative insulin-sensitivity check index, total cholesterol, LDL cholesterol, HDL cholesterol, or triglycerides (all P > 0.05).
CONCLUSION
In our sample of Brazilian adults, CD was associated with higher BMI but not with other metabolic risk factors.
背景
剖宫产会扰乱新生儿肠道微生物群的组装，并且与儿童及成人肥胖有关。然而，剖宫产是否与年轻成年人的代谢风险因素相关仍不清楚。
目的
在一项队列研究中，我们调查了随访时年龄为23至25岁的年轻成年人中剖宫产与代谢风险因素之间的关联。
设计
我们使用了巴西里贝朗普雷图一项队列研究的数据。1978年至1979年收集了6827例单胎妊娠的基线数据，23至25年后（2002年至2004年）对2063名受试者进行了随访。出生后获得了分娩类型、出生体重、母亲年龄、产次、母亲受教育程度和母亲吸烟情况等信息。在23至25岁时收集了人体测量数据、生化指标，以及参与者的受教育程度和吸烟史信息。进行线性回归以评估剖宫产与成年早期生化指标之间的关联，并控制在有向无环图中确定的一组最小混杂因素。
结果
受试者的平均年龄±标准差为23.9±0.71岁，样本中51.8%为女性。剖宫产率为32.0%，在年龄较大（P<0.001）和受教育程度较高的母亲中更常见（P<0.001）。与阴道分娩相比，多变量调整后剖宫产与较高的体重指数（BMI）相关（P<0.001），但与血糖、胰岛素抵抗的稳态模型评估、定量胰岛素敏感性检查指数、总胆固醇、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇或甘油三酯均无关（所有P>0.05）。
结论
在我们的巴西成年人样本中，剖宫产与较高的BMI相关，但与其他代谢风险因素无关。
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