Delivery mode and altered infant growth at 1 year of life in India
Background Cesarean section (C-section) delivered infants are more likely to be colonized by opportunistic pathogens, resulting in altered growth. We examined whether C-section (elective/emergency) vs vaginal delivery was associated with altered weight and linear growth at 1 year of life. Methods A...
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Veröffentlicht in: | Pediatric research 2021-12, Vol.90 (6), p.1251-1257 |
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Sprache: | eng |
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Zusammenfassung: | Background
Cesarean section (C-section) delivered infants are more likely to be colonized by opportunistic pathogens, resulting in altered growth. We examined whether C-section (elective/emergency) vs vaginal delivery was associated with altered weight and linear growth at 1 year of life.
Methods
A total of 638 mother–infant pairs were included from MAASTHI cohort 2016–2019. Information on delivery mode was obtained from medical records. Based on WHO child growth standards, body mass index-forage
z
-score (BMI
z
) and length-for-age
z
-score (length
z
) were derived. We ran multivariable linear and Poisson regression models before and after multiple imputation.
Results
The rate of C-section was 43.4% (26.5%: emergency, 16.9%: elective). Percentage of infant overweight was 14.9%. Compared to vaginal delivery, elective C-section was associated with
β
= 0.57 (95% CI 0.20, 0.95) higher BMI
z
. Also infants born by elective C-section had RR = 2.44 (95% CI 1.35, 4.41) higher risk of being overweight; no such association was found for emergency C-section. Also, elective C-section delivery was associated with reduced linear growth at 1 year after multiple imputation (
β
= −0.38, 95% CI −0.76, −0.01).
Conclusions
Elective C-section delivery might contribute to excess weight and also possibly reduced linear growth at 1 year of age in children from low- and middle-income countries.
Impact
Our study, in a low-income setting, suggests that elective, but not emergency, C-section is associated with excess infant BMI
z
at 1 year of age and elective C (C-section) was also associated with altered linear growth but only in multiple imputation analyses.
Elective C-section was associated with a higher risk of being overweight at 1 year of age.
Our results indicate that decreasing medically unnecessary elective C-section deliveries may help limit excess weight gain and stunted linear growth among infants. |
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ISSN: | 0031-3998 1530-0447 |
DOI: | 10.1038/s41390-021-01417-6 |