Association of caesarean delivery with child adiposity from age 6 weeks to 15 years.
Association of caesarean delivery with child adiposity from age 6 weeks to 15 years.
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DOI：
10.1038/ijo.2013.49
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发表时间：
2013-07
影响因子：
4.9
通讯作者：
Trasande, L.
中科院分区：
文献类型：
--
作者：
Blustein, J.;Attina, T.;Liu, M.;Ryan, A. M.;Cox, L. M.;Blaser, M. J.;Trasande, L.
评估剖腹产与从出生到青春期体重的关系。纵向出生队列研究，随访受试者至15岁。1991-1992年出生于英国雅芳的儿童，参加了雅芳父母和儿童纵向研究[ALSPAC]（n = 10，219）。主要结局：体重标准化测量（6周、10个月和20个月时的身高体重z评分; 38个月、7年、9年、11年和15年时的体重指数[BMI] z评分）。次要结局：38个月、7、9、11和15岁时，年龄和性别的分类超重或肥胖（BMI >= 85百分位数）。在10 219名儿童中，926名（9.06%）是剖腹产。剖腹产出生的婴儿出生体重低于阴道出生的婴儿（− 46.1 g，95% CI：14.6 - 77.6 g; p = 0.004）。在调整出生体重、性别、父母体重、家庭社会人口统计学、妊娠因素和婴儿喂养模式的混合多变量模型中，剖腹产与6周开始的肥胖增加一致相关（+0.11 SD单位，95% CI 0.03至0.18; p=0.005），直至15岁（BMI z评分增量+0.10 SD单位，95% CI 0.001至0.198; p=0.042）。到11岁时，剖腹产分娩的儿童超重或肥胖的几率为1.83倍（95% CI：1.24至2.70; p=0.002）。当样本按母亲孕前体重分层时，超重/肥胖母亲所生子女之间的关联是强而持久的。相比之下，正常体重母亲所生的孩子之间的联系证据很弱。剖腹产与儿童和青春期体重增加有关。需要进行研究以进一步描述正常体重妇女的儿童中的相关性。还需要做更多的工作来了解这种关联的机制，这可能涉及肠道微生物组相对持久的变化。
To assess associations of caesarean section with body mass from birth through adolescence. Longitudinal birth cohort study, following subjects up to 15 years of age. Children born in 1991–1992 in Avon, UK who participated in the Avon Longitudinal Study of Parents and Children [ALSPAC] (n = 10,219). Primary outcome: standardized measures of body mass (weight-for length z-scores at 6 weeks, 10, and 20 months; and Body Mass Index [BMI] z-scores at 38 months, 7, 9, 11, and 15 years). Secondary outcome: Categorical overweight or obese (BMI >= 85th percentile) for age and gender, at 38 months, 7, 9, 11, and 15 years. Of the 10,219 children, 926 (9.06%) were delivered by caesarean section. Those born by caesarean had lower birth weights than those born vaginally (−46.1g, 95% CI: 14.6 to 77.6 g; p = 0.004). In mixed multivariable models adjusting for birth weight, gender, parental body mass, family sociodemographics, gestational factors and infant feeding patterns, caesarean delivery was consistently associated with increased adiposity, starting at six weeks (+0.11 SD units, 95% CI 0.03 to 0.18; p=0.005), through age 15 (BMI z-score increment + 0.10 SD units, 95% CI 0.001 to 0.198; p=0.042). By age 11 caesarean–delivered children had 1.83 times the odds of overweight or obesity (95% CI: 1.24 to 2.70; p=0.002). When the sample was stratified by maternal pre-pregnancy weight, the association among children born of overweight/obese mothers was strong and long-lasting. In contrast, evidence of an association among children born of normal weight mothers was weak. Caesarean delivery is associated with increased body mass in childhood and adolescence. Research is needed to further characterize the association in children of normal weight women. Additional work is also needed to understand the mechanism underlying the association, which may involve relatively enduring changes in the intestinal microbiome.
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DOI：
10.1136/bmj.e4759
发表时间：
2012-09-25
期刊：
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影响因子：
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作者：
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发表时间：
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DOI：
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发表时间：
2010-06-29
影响因子：
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通讯作者：
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