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Cesarean delivery and metabolic risk factors in young adults: a Brazilian birth cohort study
Juliana Rombaldi Bernardi1, Tanara Vogel Pinheiro2, Noel Theodore Mueller3
1Biological and Health Sciences Center, University of Caxias do Sul, Caxias do Sul, Brazil; Department of Pediatrics, Porto Alegre Clinical Hospital, Faculty of Medicine, University of Rio Grande do Sul, Porto Alegre, Brazil;
Insights
Cesarean delivery is linked to higher body mass index (BMI) in young adults, but not other metabolic risks. This study examined the long-term health impacts of delivery method on metabolic health.
Area of Science:
- Public Health
- Epidemiology
- Metabolic Health
Background:
- Cesarean delivery (CD) impacts infant gut microbiome and is linked to obesity.
- The association between CD and metabolic risk factors in young adults remains unclear.
Purpose of the Study:
- To investigate the association between Cesarean delivery (CD) and metabolic risk factors in young adults.
- To analyze long-term health outcomes related to delivery method.
Main Methods:
- A cohort study in Brazil followed 2063 subjects for 23-25 years.
- Data included delivery type, birth weight, maternal factors, and adult anthropometric and biochemical measurements.
- Linear regression controlled for confounders to assess CD's association with metabolic factors.
Main Results:
- Cesarean delivery (32.0%) was associated with higher body mass index (BMI) in young adults (23-25 years).
- No significant association was found between CD and glucose, insulin resistance, or lipid profiles.
- CD was more common in older and more educated mothers.
Conclusions:
- Cesarean delivery is associated with increased BMI in young adulthood.
- CD does not appear to be linked to other key metabolic risk factors like insulin resistance or dyslipidemia in this population.
Background:
Cesarean delivery (CD) perturbs the assembly of the neonatal gut microbiome and has been associated with child and adult obesity. However, it is still unknown whether CD is associated with metabolic risk factors in young adults.
Objective:
We investigated the association of CD and metabolic risk factors in young adults in a cohort study who were 23-25 y of age at follow-up.
Design:
We used data from a cohort study in Ribeirão Preto, Brazil. Baseline data on 6827 singleton pregnancies were collected in 1978-1979, and a sample of 2063 subjects were followed up 23-25 y later (2002-2004). Information on the type of delivery, birth weight, maternal age, parity, maternal schooling, and maternal smoking was obtained after birth. Anthropometric data, biochemical measurements, and information on participant schooling and smoking history were collected at 23-25 y of age. A linear regression was performed to assess the association between CD and biochemical measurements in early adulthood, controlling for a minimum set of confounders that were identified in a directed acyclic graph.
Results:
The mean ± SD age of the subjects was 23.9 ± 0.71 y, and 51.8% of the sample were women. The CD rate was 32.0% and was more common in older (P < 0.001) and more educated mothers (P < 0.001). Compared with vaginal delivery, CD was associated with higher body mass index (BMI) after multivariable adjustment (P < 0.001) but not with glucose, homeostasis model assessment of insulin resistance, the quantitative insulin-sensitivity check index, total cholesterol, LDL cholesterol, HDL cholesterol, or triglycerides (all P > 0.05).
Conclusion:
In our sample of Brazilian adults, CD was associated with higher BMI but not with other metabolic risk factors.
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