The long-term effects of birth by caesarean section: The case for a randomised controlled trial
The long-term effects of birth by caesarean section: The case for a randomised controlled trial
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DOI：
10.1016/j.earlhumdev.2012.09.006
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发表时间：
2012-12-01
影响因子：
2.5
通讯作者：
Modi, Neena
中科院分区：
文献类型：
--
作者：
Hyde, Matthew James;Modi, Neena
剖腹产在世界范围内迅速增加，并与后代的一系列短期和长期不良后果有关。后者包括代谢综合征、1型糖尿病和哮喘的特征。虽然有几种可能的候选生物学机制，但仍然缺乏分娩方式与长期结果之间因果关系的证据。在这里，我们回顾了迄今为止的证据，并研究了未来研究可能促进理解的方法。我们的结论是，对健康足月（头位妊娠）的分娩方式进行随机对照试验既不是不道德的，也不是不可行的，应该认真考虑作为解决与公共卫生密切相关的问题的最佳方法。(C) 2012年由爱思唯尔爱尔兰有限公司出版
Birth by caesarean section is rising rapidly around the world and is associated with a range of adverse short and long-term outcomes in offspring. The latter include features of the metabolic syndrome, type-1 diabetes, and asthma. Though there are several plausible candidate biological mechanisms, evidence of a causal relationship between mode of delivery and long-term outcomes remains lacking. Here we review the evidence to date, and examine ways in which future studies might advance understanding. We conclude that a randomised controlled trial of mode of delivery for the healthy term, cephalic pregnancy, is neither unethical nor unfeasible and should be seriously considered as the optimum means of addressing a question of great relevance to public health. (C) 2012 Published by Elsevier Ireland Ltd.