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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| description | 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. |
| doi_str_mv | 10.1038/s41390-021-01417-6 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_8671090</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2609864665</sourcerecordid><originalsourceid>FETCH-LOGICAL-c474t-5327efd62a9284532ce9b7a1b8b22fcc9db3fdd3fc6ce9286b4b4346dcb401453</originalsourceid><addsrcrecordid>eNp9kUtPGzEUhS1UVFLaP8ACWeqmmwG_4rE3SJQ-QEJiA2vLY18ngyY22JNU-fd1mpTXgpVln--ee68PQkeUnFDC1WkRlGvSEEYbQgVtG7mHJnTK65MQ7Qc0IYTThmutDtCnUu5JpaZKfEQHnMupYEpN0PcfMPQryGu8SB6wjR7bYYQMHvcx2DjiWU5_xjm2I6Z4DTbjFPDQB6g6voq-t5_RfrBDgS-78xDd_fp5e3HZXN_8vro4v26caMXYTDlrIXjJrGZK1JsD3bWWdqpjLDinfceD9zw4WRWmZCc6wYX0rhObwfkhOtv6Piy7BXgHccx2MA-5X9i8Nsn25rUS-7mZpZVRsqVEk2rwbWeQ0-MSymgWfXEwDDZCWhbDhJasfle7Qb--Qe_TMse6nmGSaCWFlJuJ2JZyOZWSITwNQ4nZRGS2EZkakfkXkZG16PjlGk8l_zOpAN8CpUpxBvm59zu2fwG89ZuY</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2609864665</pqid></control><display><type>article</type><title>Delivery mode and altered infant growth at 1 year of life in India</title><source>MEDLINE</source><source>SpringerLink Journals</source><source>EZB-FREE-00999 freely available EZB journals</source><source>Alma/SFX Local Collection</source><creator>Babu, Giridhara R. ; Mueller, Noel T. ; Lewis, Melissa Glenda ; Krishnan, Anjaly ; Lobo, Eunice ; Deepa, R. ; Khetrapal, Sonalini ; Benjamin-Neelon, Sara E.</creator><creatorcontrib>Babu, Giridhara R. ; Mueller, Noel T. ; Lewis, Melissa Glenda ; Krishnan, Anjaly ; Lobo, Eunice ; Deepa, R. ; Khetrapal, Sonalini ; Benjamin-Neelon, Sara E.</creatorcontrib><description>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.</description><identifier>ISSN: 0031-3998</identifier><identifier>EISSN: 1530-0447</identifier><identifier>DOI: 10.1038/s41390-021-01417-6</identifier><identifier>PMID: 33654288</identifier><language>eng</language><publisher>New York: Nature Publishing Group US</publisher><subject>Babies ; Body mass index ; Cesarean Section ; Cohort Studies ; Delivery, Obstetric ; Female ; Growth ; Humans ; India ; Infant ; Male ; Medicine ; Medicine & Public Health ; Overweight ; Pediatric Obesity ; Pediatric Surgery ; Pediatrics ; Physical growth ; Population Study ; Population Study Article ; Pregnancy ; Vagina</subject><ispartof>Pediatric research, 2021-12, Vol.90 (6), p.1251-1257</ispartof><rights>The Author(s) 2021</rights><rights>2021. The Author(s).</rights><rights>The Author(s) 2021. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c474t-5327efd62a9284532ce9b7a1b8b22fcc9db3fdd3fc6ce9286b4b4346dcb401453</citedby><cites>FETCH-LOGICAL-c474t-5327efd62a9284532ce9b7a1b8b22fcc9db3fdd3fc6ce9286b4b4346dcb401453</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1038/s41390-021-01417-6$$EPDF$$P50$$Gspringer$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1038/s41390-021-01417-6$$EHTML$$P50$$Gspringer$$Hfree_for_read</linktohtml><link.rule.ids>230,314,776,780,881,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33654288$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Babu, Giridhara R.</creatorcontrib><creatorcontrib>Mueller, Noel T.</creatorcontrib><creatorcontrib>Lewis, Melissa Glenda</creatorcontrib><creatorcontrib>Krishnan, Anjaly</creatorcontrib><creatorcontrib>Lobo, Eunice</creatorcontrib><creatorcontrib>Deepa, R.</creatorcontrib><creatorcontrib>Khetrapal, Sonalini</creatorcontrib><creatorcontrib>Benjamin-Neelon, Sara E.</creatorcontrib><title>Delivery mode and altered infant growth at 1 year of life in India</title><title>Pediatric research</title><addtitle>Pediatr Res</addtitle><addtitle>Pediatr Res</addtitle><description>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.</description><subject>Babies</subject><subject>Body mass index</subject><subject>Cesarean Section</subject><subject>Cohort Studies</subject><subject>Delivery, Obstetric</subject><subject>Female</subject><subject>Growth</subject><subject>Humans</subject><subject>India</subject><subject>Infant</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Overweight</subject><subject>Pediatric Obesity</subject><subject>Pediatric Surgery</subject><subject>Pediatrics</subject><subject>Physical growth</subject><subject>Population Study</subject><subject>Population Study Article</subject><subject>Pregnancy</subject><subject>Vagina</subject><issn>0031-3998</issn><issn>1530-0447</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>C6C</sourceid><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNp9kUtPGzEUhS1UVFLaP8ACWeqmmwG_4rE3SJQ-QEJiA2vLY18ngyY22JNU-fd1mpTXgpVln--ee68PQkeUnFDC1WkRlGvSEEYbQgVtG7mHJnTK65MQ7Qc0IYTThmutDtCnUu5JpaZKfEQHnMupYEpN0PcfMPQryGu8SB6wjR7bYYQMHvcx2DjiWU5_xjm2I6Z4DTbjFPDQB6g6voq-t5_RfrBDgS-78xDd_fp5e3HZXN_8vro4v26caMXYTDlrIXjJrGZK1JsD3bWWdqpjLDinfceD9zw4WRWmZCc6wYX0rhObwfkhOtv6Piy7BXgHccx2MA-5X9i8Nsn25rUS-7mZpZVRsqVEk2rwbWeQ0-MSymgWfXEwDDZCWhbDhJasfle7Qb--Qe_TMse6nmGSaCWFlJuJ2JZyOZWSITwNQ4nZRGS2EZkakfkXkZG16PjlGk8l_zOpAN8CpUpxBvm59zu2fwG89ZuY</recordid><startdate>20211201</startdate><enddate>20211201</enddate><creator>Babu, Giridhara R.</creator><creator>Mueller, Noel T.</creator><creator>Lewis, Melissa Glenda</creator><creator>Krishnan, Anjaly</creator><creator>Lobo, Eunice</creator><creator>Deepa, R.</creator><creator>Khetrapal, Sonalini</creator><creator>Benjamin-Neelon, Sara E.</creator><general>Nature Publishing Group US</general><general>Nature Publishing Group</general><scope>C6C</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8C1</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20211201</creationdate><title>Delivery mode and altered infant growth at 1 year of life in India</title><author>Babu, Giridhara R. ; Mueller, Noel T. ; Lewis, Melissa Glenda ; Krishnan, Anjaly ; Lobo, Eunice ; Deepa, R. ; Khetrapal, Sonalini ; Benjamin-Neelon, Sara E.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c474t-5327efd62a9284532ce9b7a1b8b22fcc9db3fdd3fc6ce9286b4b4346dcb401453</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Babies</topic><topic>Body mass index</topic><topic>Cesarean Section</topic><topic>Cohort Studies</topic><topic>Delivery, Obstetric</topic><topic>Female</topic><topic>Growth</topic><topic>Humans</topic><topic>India</topic><topic>Infant</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Overweight</topic><topic>Pediatric Obesity</topic><topic>Pediatric Surgery</topic><topic>Pediatrics</topic><topic>Physical growth</topic><topic>Population Study</topic><topic>Population Study Article</topic><topic>Pregnancy</topic><topic>Vagina</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Babu, Giridhara R.</creatorcontrib><creatorcontrib>Mueller, Noel T.</creatorcontrib><creatorcontrib>Lewis, Melissa Glenda</creatorcontrib><creatorcontrib>Krishnan, Anjaly</creatorcontrib><creatorcontrib>Lobo, Eunice</creatorcontrib><creatorcontrib>Deepa, R.</creatorcontrib><creatorcontrib>Khetrapal, Sonalini</creatorcontrib><creatorcontrib>Benjamin-Neelon, Sara E.</creatorcontrib><collection>Springer Nature OA Free Journals</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Public Health Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Pediatric research</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Babu, Giridhara R.</au><au>Mueller, Noel T.</au><au>Lewis, Melissa Glenda</au><au>Krishnan, Anjaly</au><au>Lobo, Eunice</au><au>Deepa, R.</au><au>Khetrapal, Sonalini</au><au>Benjamin-Neelon, Sara E.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Delivery mode and altered infant growth at 1 year of life in India</atitle><jtitle>Pediatric research</jtitle><stitle>Pediatr Res</stitle><addtitle>Pediatr Res</addtitle><date>2021-12-01</date><risdate>2021</risdate><volume>90</volume><issue>6</issue><spage>1251</spage><epage>1257</epage><pages>1251-1257</pages><issn>0031-3998</issn><eissn>1530-0447</eissn><abstract>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.</abstract><cop>New York</cop><pub>Nature Publishing Group US</pub><pmid>33654288</pmid><doi>10.1038/s41390-021-01417-6</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0031-3998 |
| ispartof | Pediatric research, 2021-12, Vol.90 (6), p.1251-1257 |
| issn | 0031-3998 1530-0447 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_8671090 |
| source | MEDLINE; SpringerLink Journals; EZB-FREE-00999 freely available EZB journals; Alma/SFX Local Collection |
| subjects | Babies Body mass index Cesarean Section Cohort Studies Delivery, Obstetric Female Growth Humans India Infant Male Medicine Medicine & Public Health Overweight Pediatric Obesity Pediatric Surgery Pediatrics Physical growth Population Study Population Study Article Pregnancy Vagina |
| title | Delivery mode and altered infant growth at 1 year of life in India |
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