Department of Reproductive Health and Midwifery, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.
Department of Midwifery, Varamin-Pishva Branch, Islamic Azad University, Varamin, Iran.
J Obstet Gynaecol Res. 2022 Jul;48(7):1768-1774. doi: 10.1111/jog.15251. Epub 2022 Apr 5.
Adipokines are involved in inflammatory responses, associated with body mass index whose concentrations may change in response to inflammatory conditions, including surgery and delivery. We examined adiponectin and leptin levels and their gene expression at birth, body mass index, and breastfeeding duration at 24 months postpartum according to mode of delivery.
In this study, 90 normal pregnant women were investigated. Blood samples were collected after delivery. Serum levels and gene expression of adiponectin and leptin were evaluated. Body mass index and breastfeeding duration were calculated at 24 months postpartum. Data were analyzed using SPSS-16 and p < 0.05 was considered as significant.
Serum leptin level was significantly higher in vaginal delivery than in cesarean section (p = 0.033). No significant difference was found between two groups regarding adiponectin level and gene expression, while leptin gene expression was significantly higher in cesarean (p = 0.005). Postpartum body mass index did not differ between the two groups (p = 0.14). On the other hand, postpartum body mass index was significantly higher than the equivalent prepregnancy index in both groups (p < 0.001) and was associated with serum leptin and adiponectin in vaginal delivery (r = 0.46, p = 0.001, and r = -0.3, p = 0.04, respectively). The duration of breastfeeding was longer in vaginal delivery (p = 0.008).
Cesarean section was associated with lower maternal leptin levels and shorter breast-feeding duration compared to vaginal delivery. Leptin gene expression was significantly higher in cesarean section than in vaginal delivery. Postpartum body mass index, adiponectin level, and gene expression did not differ between the two groups.
脂肪因子参与炎症反应,与体重指数有关,其浓度可能因炎症状态而改变,包括手术和分娩。我们根据分娩方式,在出生时、产后 24 个月时的体重指数和母乳喂养持续时间,检查了瘦素和脂联素的水平及其基因表达。
本研究纳入了 90 名正常孕妇。分娩后采集血样。评估了瘦素和脂联素的血清水平和基因表达。产后 24 个月时计算体重指数和母乳喂养持续时间。使用 SPSS-16 进行数据分析,p<0.05 为差异有统计学意义。
阴道分娩的血清瘦素水平明显高于剖宫产(p=0.033)。两组之间脂联素水平和基因表达无显著差异,而剖宫产组瘦素基因表达明显更高(p=0.005)。两组产后体重指数无差异(p=0.14)。另一方面,两组产后体重指数均明显高于孕前指数(p<0.001),且与阴道分娩时的血清瘦素和脂联素相关(r=0.46,p=0.001 和 r=-0.3,p=0.04)。阴道分娩的母乳喂养时间较长(p=0.008)。
与阴道分娩相比,剖宫产与母亲瘦素水平较低和母乳喂养时间较短有关。剖宫产组瘦素基因表达明显高于阴道分娩组。两组产后体重指数、脂联素水平和基因表达无差异。