Delivery by caesarean section and risk of childhood obesity: analysis of a Peruvian prospective cohort
Delivery by caesarean section and risk of childhood obesity: analysis of a Peruvian prospective cohort
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DOI：
10.7717/peerj.1046
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发表时间：
2015-06-23
期刊：
影响因子：
2.7
通讯作者：
Bernabe-Ortiz, Antonio
中科院分区：
文献类型：
--
作者：
Carrillo-Larco, Rodrigo M.;Jaime Miranda, J.;Bernabe-Ortiz, Antonio
目标。我们的目的是评估剖腹产是否是儿童早期和晚期营养过剩的风险因素，并评估与儿童和家庭相关的变量在这些风险估计中的影响程度。研究使用了来自年轻生活研究的秘鲁儿童的纵向数据。评估的结果是在5岁(第一次随访)和7岁(第二次随访)时超重、肥胖、营养过剩(超重加肥胖)和中心性肥胖(腰围)。利益的暴露是通过剖腹产进行的。使用多变量模型计算相对危险度(RR)和95%可信区间(95%CI)，并对儿童相关变量(如出生体重)和家庭相关变量(如母亲营养状况)进行调整。基线时，平均年龄为11.7(+/-3.5)个月，其中50.1%是男孩。剖宫产新生儿占15.6%。10.5%的儿童超重，2.4%的儿童肥胖。对于肥胖结果，分别包括了从基线到第一次和第二次随访的6,038和9,625名儿童的数据。与没有剖腹产经历的人相比，剖腹产出生的人肥胖的风险更高：儿童早期(第一次随访：2.25；95%CI[1.36-3.74])的RR高于生活后期(第二次随访：1.57；95%CI[1.02-2.41])。家庭相关变量在第一次比第二次随访时对肥胖风险估计的影响更大。我们的结果表明，剖腹产出生的孩子患肥胖症的可能性更高，但不会超重。风险估计的大小随着时间的推移而减少，家庭相关变量对儿童早期的风险估计有更强的影响。
Objectives. We aimed to assess if Caesarean section is a risk factor for overnutrition in early- and late-childhood, and to assess the magnitude of the effect of child- versus family-related variables in these risk estimates.Methods. Longitudinal data from Peruvian children from the Young Lives Study was used. Outcomes assessed were overweight, obesity, overnutrition (overweight plus obesity), and central obesity (waist circumference) at the age 5 (first follow-up) and 7 (second follow-up) years. The exposure of interests was delivery by Caesarean section. Relative risks (RR) and 95% confidence intervals (95% CI) were calculated using multivariable models adjusted for child-related (e.g., birth weight) and family-related (e.g., maternal nutritional status) variables.Results. At baseline, mean age was 11.7 (+/- 3.5) months and 50.1% were boys. Children born by Caesarean section were 15.6%. The 10.5% of the children were overweight and 2.4% were obese. For the obesity outcome, data from 6,038 and 9,625 children-years was included from baseline to the first and second follow-up, respectively. Compared to those who did not experience Caesarean delivery, the risk of having obesity was higher in the group born by Caesarean: RRs were higher at early-childhood (first follow-up: 2.25; 95% CI [1.36-3.74]) than later in life (second follow-up: 1.57; 95% CI [1.02-2.41]). Family-related variables had a greater effect in attenuating the risk estimates for obesity at the first, than at the second follow-up.Conclusion. Our results suggest a higher probability of developing obesity, but not overweight, among children born by Caesarean section delivery. The magnitude of risk estimates decreased over time, and family-related variables had a stronger effect on the risk estimates at early-childhood.