NCD Center of Excellence, Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand.
Liggins Institute, University of Auckland, Auckland, New Zealand.
Sci Rep. 2021 May 13;11(1):10201. doi: 10.1038/s41598-021-89438-3.
We examined the associations between caesarean section (CS) delivery and cardiovascular risk factors in young adults in Thailand. Participants were 632 offspring from a birth cohort in Chiang Mai (Northern Thailand), born in 1989-1990 and assessed in 2010 at a mean age of 20.6 years, including 57 individuals (9.0%) born by CS and 575 born vaginally. Clinical assessments included anthropometry, blood pressure (BP), carotid intima-media thickness, and fasting blood glucose, insulin, and lipid profile. Young adults born by CS had systolic BP (SBP) 6.2 mmHg higher (p < 0.001), diastolic BP 3.2 mmHg higher (p = 0.029), and mean arterial pressure (MAP) 4.1 mmHg higher (p = 0.003) than those born vaginally. After covariate adjustments, SBP and MAP remained 4.1 mmHg (p = 0.006) and 2.9 mmHg (p = 0.021) higher, respectively, in the CS group. The prevalence of abnormal SBP (i.e., pre-hypertension or hypertension) in the CS group was 2.5 times that of those born vaginally (25.0% vs 10.3%; p = 0.003), with an adjusted relative risk of abnormal SBP 1.9 times higher (95% CI 1.15, 2.98; p = 0.011). There were no differences in anthropometry (including obesity risk) or other metabolic parameters. In this birth cohort in Thailand, CS delivery was associated with increased blood pressure in young adulthood.
我们研究了在泰国的年轻成年人中剖宫产（CS）分娩与心血管危险因素之间的关联。参与者是清迈（泰国北部）出生队列中的 632 名后代，他们于 1989-1990 年出生，在 2010 年平均年龄为 20.6 岁时进行了评估，包括 57 名（9.0%）通过 CS 分娩的婴儿和 575 名经阴道分娩的婴儿。临床评估包括人体测量、血压（BP）、颈动脉内膜中层厚度以及空腹血糖、胰岛素和血脂谱。通过 CS 分娩的年轻成年人的收缩压（SBP）高 6.2mmHg（p<0.001），舒张压高 3.2mmHg（p=0.029），平均动脉压（MAP）高 4.1mmHg（p=0.003）。经过协变量调整后，CS 组的 SBP 和 MAP 仍然分别高 4.1mmHg（p=0.006）和 2.9mmHg（p=0.021）。CS 组异常 SBP（即高血压前期或高血压）的患病率是经阴道分娩组的 2.5 倍（25.0% vs 10.3%；p=0.003），调整后的异常 SBP 相对风险高 1.9 倍（95%CI 1.15，2.98；p=0.011）。两组在人体测量（包括肥胖风险）或其他代谢参数方面没有差异。在这项来自泰国的出生队列研究中，CS 分娩与年轻人血压升高有关。
