Delivery by Caesarean section and infant cardiometabolic status at one year of age.
OBJECTIVE
Disruption of the gut microbiome has been associated with overweight/obesity, insulin resistance, and type 2 diabetes. Recently, it has been reported that Caesarean section disrupts the normal gut microbiome of neonates. As such, these data have raised the intriguing possibility that CS could lead to an adverse cardiometabolic risk profile early in life. Thus, we sought to compare the cardiometabolic status of infants delivered by CS to that of infants delivered vaginally.


METHODS
In this prospective observational cohort study, 104 women underwent cardiometabolic evaluation in pregnancy followed by similar assessment of their infants at one year of age, thereby enabling comparison of infants delivered vaginally (n = 74) to those delivered by CS (n = 30). Infant assessment included anthropometric evaluation and measurement of variables associated with cardiometabolic risk.


RESULTS
At one year of age, there were no differences between infants delivered vaginally and those delivered by CS with respect to mean BMI, sum of skinfolds, fasting glucose, insulin resistance, total cholesterol, LDL cholesterol, HDL cholesterol, triglycerides, C-reactive protein, leptin, and adiponectin, both before and after covariate adjustment. Of note, maternal and infant levels of adiponectin (r = 0.31, P = 0.007) and of total cholesterol, LDL-cholesterol, and HDL-cholesterol (all r ≥ 0.23, P < 0.05) were associated in the vaginal delivery group only, whereas the analogous association for leptin was observed only in the CS group (r = 0.44, P = 0.02).


CONCLUSIONS
Caesarean section was not found to be associated with an adverse infant cardiometabolic risk profile at one year of age, although it potentially may affect the impact of maternal determinants of this profile.
Leadership Sinai Centre for Diabetes, Mount Sinai Hospital, Toronto ON.
Jenna
J
Haji
Department of Pediatrics, Hospital for Sick Children, Toronto ON.
Jill K
JK
Hamilton
Leadership Sinai Centre for Diabetes, Mount Sinai Hospital, Toronto ON.
Chang
C
Ye
Leadership Sinai Centre for Diabetes, Mount Sinai Hospital, Toronto ON.
Balakumar
B
Swaminathan
Leadership Sinai Centre for Diabetes, Mount Sinai Hospital, Toronto ON; Division of Endocrinology, University of Toronto, Toronto ON; Department of Nutritional Sciences, University of Toronto, Toronto ON.
Anthony J
AJ
Hanley
Department of Obstetrics and Gynaecology, Mount Sinai Hospital, Toronto ON.
Mathew
M
Sermer
Division of Endocrinology, University of Toronto, Toronto ON; Keenan Research Centre for Biomedical Science, St. Michael's Hospital, Toronto ON.
Philip W
PW
Connelly
Leadership Sinai Centre for Diabetes, Mount Sinai Hospital, Toronto ON; Division of Endocrinology, University of Toronto, Toronto ON; Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, Toronto ON.
Bernard
B
Zinman
Leadership Sinai Centre for Diabetes, Mount Sinai Hospital, Toronto ON; Division of Endocrinology, University of Toronto, Toronto ON; Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, Toronto ON.
Ravi
R
Retnakaran
D001786:Blood Glucose / Q000378:metabolism*; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000097:blood / Q000378:metabolism / Q000382:microbiology; D002585:Cesarean Section; D002784:Cholesterol / Q000097:blood*; D036861:Delivery, Obstetric; D005260:Female; D006801:Humans; D007223:Infant; D007328:Insulin / Q000097:blood*; D011247:Pregnancy; D011446:Prospective Studies; D012307:Risk Factors
D001786:Blood Glucose; D007328:Insulin; D002784:Cholesterol
Caesarean; cardiovascular risk; gut microbiome; infant; mode of delivery