Division of Chronic Disease Research Across the Lifecourse, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts, USA.
Division of Gastroenterology, Hepatology and Nutrition, Boston Children's Hospital, Boston, Massachusetts, USA.
Pediatr Obes. 2021 Sep;16(9):e12783. doi: 10.1111/ijpo.12783. Epub 2021 Mar 3.
Caesarean delivery has been associated with later adiposity, perhaps via early programming or perhaps because of residual confounding by maternal or birth characteristics.
Examine associations of caesarean delivery with adiposity and cardio-metabolic biomarkers.
Observational analysis of 15 069 children in the PROBIT cohort in Belarus. We examined measures of child anthropometry and blood pressure at 6.5, 11.5 and 16 years and fasting blood (11.5 years).
Caesarean-delivered children were slightly heavier at 6.5 (mean BMI 15.8 vs. 15.6 kg/m ), 11.5 (18.4 vs. 18.2) and 16 years (21.5 vs. 21.3). After adjustment for prenatal characteristics including maternal third trimester BMI, however, we observed no association of caesarean versus vaginal delivery with child BMI (β 0.05 kg/m ; 95%CI: -0.03, 0.14), sum of skinfolds (0.14 mm; -0.13, 0.42), waist circumference (-0.07 cm; -0.23, 0.10), obesity (OR 0.99; 0.76, 1.29), or systolic (-0.20 mmHg; -0.70, 0.30) or diastolic (-0.17 mmHg, -0.60, 0.26) blood pressure at 6.5 years; results were similar at 11.5 and 16 years. At 11.5 years, we observed a modest association of caesarean delivery with fasting insulin (0.33 mU/L; 0.00, 0.65).
Caesarean delivery had little or no association with adiposity or related cardio-metabolic biomarkers in childhood. Adjustment for maternal BMI attenuated all outcome effect estimates.
剖宫产与后期肥胖有关，这可能是通过早期编程，也可能是由于产妇或分娩特征的残余混杂。
研究剖宫产与肥胖和心血管代谢生物标志物的关系。
对白俄罗斯 PROBIT 队列中的 15069 名儿童进行观察性分析。我们检查了儿童在 6.5 岁、11.5 岁和 16 岁时的人体测量和血压测量，以及 11.5 岁时的空腹血样。
剖宫产儿童在 6.5 岁（平均 BMI 为 15.8 千克/米，15.6 千克/米）、11.5 岁（18.4 千克/米，18.2 千克/米）和 16 岁（21.5 千克/米，21.3 千克/米）时体重略重。然而，在校正了包括母亲孕晚期 BMI 在内的产前特征后，我们观察到剖宫产与阴道分娩与儿童 BMI（β 0.05 千克/米；95%CI：-0.03，0.14）、皮褶总和（0.14 毫米；-0.13，0.42）、腰围（-0.07 厘米；-0.23，0.10）、肥胖（OR 0.99；0.76，1.29）或收缩压（-0.20 毫米汞柱；-0.70，0.30）或舒张压（-0.17 毫米汞柱，-0.60，0.26）在 6.5 岁时无关联；11.5 岁和 16 岁时的结果相似。在 11.5 岁时，我们观察到剖宫产与空腹胰岛素（0.33 毫摩尔/升；0.00，0.65）有适度关联。
剖宫产与儿童肥胖或相关心血管代谢生物标志物的关系很小或没有关系。调整产妇 BMI 后，所有结局效应估计值都有所减弱。
