Veile Amanda, Valeggia Claudia, Kramer Karen L
Department of Anthropology, Purdue University, West Lafayette, Indiana.
Department of Anthropology, Yale University, New Haven, Connecticut.
Am J Hum Biol. 2019 Mar;31(2):e23228. doi: 10.1002/ajhb.23228. Epub 2019 Feb 28.
Cesarean delivery is often epidemiologically associated with childhood obesity. However, little attention is paid to post-birth modulatory environments, and most studies are conducted in settings where obesity arises for a number of reasons in addition to birth mode. We therefore assess population differences in the relationship between birth mode and childhood growth using data from rural and peri-urban Latin American indigenous populations, and test predictions developed using life history theory.
Child height and weight were measured monthly in 80 Yucatec Maya and 58 Toba/Qom children aged 1-48 months (2007-2014, 3812 observations). Random-effects linear mixed models were used to compare children's growth by population, sex, and birth mode, accounting for potential confounders.
Cesarean delivery rates were 47% (Toba/Qom) and 20% (Yucatec Maya). Childhood obesity and overweight rates were low in both populations. Cesarean-delivered children had significantly greater weight gain (but similar height grain) compared to vaginally-delivered children. By age 4, cesarean delivered Yucatec Maya girls and boys, and Toba/Qom boys (not girls), had significantly higher weight-for-age compared to vaginally-delivered children from their own sex and population.
This provides one of the first attempts to document differences in children's growth patterns according to mode of birth in modernizing indigenous populations. Cesarean delivery is associated with young children's growth patterns, even in the absence of many obesity-inducing factors. There are also population, age, and sex differences in the relationship between birth mode and childhood weight trajectories that warrant future investigation.
剖宫产在流行病学上常与儿童肥胖相关。然而，产后调节环境很少受到关注，并且大多数研究是在除出生方式外还存在多种导致肥胖因素的环境中进行的。因此，我们利用拉丁美洲农村和城郊土著人口的数据评估出生方式与儿童生长之间关系的人群差异，并检验基于生命史理论得出的预测。
对80名尤卡坦玛雅儿童和58名托巴/孔儿童（年龄1至48个月，2007 - 2014年，共3812次观察）每月测量身高和体重。采用随机效应线性混合模型，比较不同人群、性别和出生方式的儿童生长情况，并考虑潜在混杂因素。
剖宫产率分别为47%（托巴/孔）和20%（尤卡坦玛雅）。两个群体的儿童肥胖和超重率都较低。与顺产儿童相比，剖宫产儿童体重增加显著更多（但身高增长相似）。到4岁时，剖宫产的尤卡坦玛雅女孩和男孩以及托巴/孔男孩（女孩未出现此情况），与同性别、同群体的顺产儿童相比，年龄别体重显著更高。
这是首次尝试记录现代化进程中土著人口根据出生方式不同的儿童生长模式差异。剖宫产与幼儿生长模式相关，即使在没有许多致胖因素的情况下也是如此。出生方式与儿童体重轨迹之间的关系还存在人群、年龄和性别差异，值得未来进一步研究。
