Mode of delivery and offspring body mass index, overweight and obesity in adult life: a systematic review and meta-analysis.
Mode of delivery and offspring body mass index, overweight and obesity in adult life: a systematic review and meta-analysis.
复制标题
DOI：
10.1371/journal.pone.0087896
复制
发表时间：
2014
期刊：
影响因子：
3.7
通讯作者：
Modi N
中科院分区：
文献类型：
--
作者：
Darmasseelane K;Hyde MJ;Santhakumaran S;Gale C;Modi N
有人认为，分娩方式对长期健康具有潜在的强大影响，可能会影响以后的体重指数（BMI）。我们对剖腹产（CS）和阴道分娩（VD）对后代成年期BMI、超重（BMI>25）和肥胖（BMI>30）的影响进行了系统回顾和荟萃分析。次要结果是按性别和 CS 类型（临产/紧急、临产前/选择性）进行的亚组分析。使用预定义的搜索策略，Pubmed、Google Scholar 和 Web of Science 搜索了 2012 年 3 月 31 日之前发表的任何文章，以及任何被认为相关的研究的参考文献。如果研究报告了出生特征和后代成年期的长期随访，则选择这些研究。相关研究的汇总数据被提取到预先试点的数据表中。在 RevMan5 中进行了随机效应荟萃分析。结果使用森林图和漏斗图进行说明，并以平均差或比值比 (OR) 和 95% 置信区间的形式呈现。通过检索确定了 35 项研究，其中 15 项研究（总人群为 163,753 人）适合纳入荟萃分析。在汇总性别未调整分析中比较所有 CS 与 VD，平均 BMI 差异为 0·44 kg·m-2 (0·17, 0·72; p = 0·002)，超重发生率的 OR 为 1·26 (1·16, 1·38; p<0·00001)，肥胖发生率的 OR 为 1·22 (1·05, p<0·00001)。 1·42； p = 0·01)。所有主要分析的异质性都很低。在特定性别的亚组分析中也发现了类似的结果。比较 CS 和 VD 类型的亚组分析显示对任何结果均没有显着影响。 CS 与后代 BMI 增加、成年后超重和肥胖有很强的相关性。鉴于全球 CS 率不断上升，有必要确定这是否是因果关系，还是反映了混杂影响。先验协议在PROSPERO上注册（注册号：CRD42011001851）
It has been suggested that mode of delivery, a potentially powerful influence upon long-term health, may affect later life body mass index (BMI). We conducted a systematic review and meta-analysis of the effect of Caesarean section (CS) and vaginal delivery (VD) on offspring BMI, overweight (BMI>25) and obesity (BMI>30) in adulthood. Secondary outcomes were subgroup analyses by gender and type of CS (in-labour/emergency, pre-labour/elective). Using a predefined search strategy, Pubmed, Google Scholar and Web of Science were searched for any article published before 31st March 2012, along with references of any studies deemed relevant. Studies were selected if they reported birth characteristics and long-term offspring follow-up into adulthood. Aggregate data from relevant studies were extracted onto a pre-piloted data table. A random-effects meta-analysis was carried out in RevMan5. Results are illustrated using forest plots and funnel plots, and presented as mean differences or odds ratios (OR) and 95% confidence intervals. Thirty-five studies were identified through the search, and 15 studies with a combined population of 163,753 were suitable for inclusion in the meta-analysis. Comparing all CS to VD in pooled-gender unadjusted analyses, mean BMI difference was 0·44 kg·m-2 (0·17, 0·72; p = 0·002), OR for incidence of overweight was 1·26 (1·16, 1·38; p<0·00001) and OR for incidence of obesity was 1·22 (1·05, 1·42; p = 0·01). Heterogeneity was low in all primary analyses. Similar results were found in gender-specific subgroup analyses. Subgroup analyses comparing type of CS to VD showed no significant impact on any outcome. There is a strong association between CS and increased offspring BMI, overweight and obesity in adulthood. Given the rising CS rate worldwide there is a need to determine whether this is causal, or reflective of confounding influences. An a priori protocol was registered on PROSPERO (registration number: CRD42011001851)
登录
查看更多内容
DOI：
10.1136/bmj.c5065
发表时间：
2010-10-06
期刊：
BMJ (Clinical research ed.)
影响因子：
--
作者：
Bragg F;Cromwell DA;Edozien LC;Gurol-Urganci I;Mahmood TA;Templeton A;van der Meulen JH
通讯作者：
van der Meulen JH
影响因子：
5
作者：
Harder, T;Bergmann, R;Plagemann, A
通讯作者：
Plagemann, A
DOI：
10.1001/archpedi.1995.02170210036006
发表时间：
1995-08-01
影响因子：
--
作者：
ANNIBALE, DJ;HULSEY, TC;SOUTHGATE, WM
通讯作者：
SOUTHGATE, WM
影响因子：
14.2
作者：
Bager, P;Melbye, M;Westergaard, T
通讯作者：
Westergaard, T
影响因子：
5.8
作者：
Fall, CHD;Dennison, E;Hindmarsh, P
通讯作者：
Hindmarsh, P