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Progression of C-reactive protein from birth through preadolescence varies by mode of delivery

Alexandra R Sitarik1, Christine C Johnson1, Albert M Levin1

  • 1Department of Public Health Sciences, Henry Ford Health, Detroit, MI, United States.

Frontiers in Pediatrics
|June 30, 2023
PubMed

Insights

Planned C-sections are linked to higher childhood inflammation and BMI, unlike emergency C-sections. Experiencing labor may reduce long-term chronic disease risk by lowering systemic inflammation.

Area of Science:

  • Pediatric chronic disease
  • Inflammation markers
  • Birth outcomes

Background:

  • Caesarean section (C-section) delivery is associated with increased childhood chronic disease risk, potentially due to systemic inflammation.
  • Specific C-section types may have differential impacts, with emergency C-sections often involving labor or membrane rupture.

Purpose of the Study:

  • To investigate the association between delivery mode and longitudinal high-sensitivity C-reactive protein (hs-CRP) profiles from birth to preadolescence.
  • To determine if hs-CRP mediates the relationship between delivery mode and preadolescent body mass index (BMI).

Main Methods:

  • Analysis of data from the WHEALS birth cohort (N=564).
  • Longitudinal plasma hs-CRP levels measured from birth through 10 years of age.
  • Growth mixture models (GMMs) used to identify hs-CRP trajectories; Poisson regression for risk ratios.

Main Results:

  • Two hs-CRP trajectories identified: low (76%) and high/increasing (24%).
  • Planned C-section delivery increased the risk of high hs-CRP trajectory (RR=1.15, p=0.028) compared to vaginal delivery.
  • No association found for unplanned C-section; hs-CRP class mediated 43.4% of the planned C-section effect on BMI z-score at age 10.

Conclusions:

  • Experiencing labor may lead to lower childhood systemic inflammation and reduced preadolescent BMI.
  • Findings suggest potential benefits of labor for mitigating long-term chronic disease development.
  • Mode of delivery and labor experience may influence inflammatory pathways impacting childhood health outcomes.
Abstract

Keywords:
birth cohortcaesarean sectiondevelopmental origins of health and diseasehigh-sensitivity C-reactive proteininflammation

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