title: Changes in Maternal Plasma Adiponectin from Late Pregnancy to the Postpartum Period According to the Mode of Delivery: Results from a Prospective Cohort in Rio de Janeiro, Brazil.
abstract: BACKGROUND
  Maternal plasma adiponectin is inversely related to insulin resistance, atherosclerosis and child health. However, little is known about its concentrations in the perinatal period, especially according to mode of delivery. Our aim is to evaluate the association between mode of delivery and changes in maternal plasma adiponectin from 3rd trimester of pregnancy to 30-45 days postpartum.
  
  
  METHODS
  A cohort was recruited in Rio de Janeiro, Brazil, with four waves of follow-up: 5-13th, 22-26th, 30-36th gestational weeks and 30-45 days postpartum. Eligible subjects should be between 20-40 years of age, be free of chronic and infectious diseases and presenting with a singleton pregnancy. The mode of delivery was classified as vaginal (VD) or cesarean (CS). Plasma adiponectin concentration (μg/mL) was measured using commercial ELISA kits. Statistical analyses included the Wilcoxon rank-sum test and the multiple linear mixed effects model.
  
  
  RESULTS
  A total of 159 participated in the study. Median adiponectin concentrations were higher for the VD group (n = 99; 8.25, IQR: 5.85-11.90) than for the CS group (n = 60; 7.34, IQR: 4.36-9.76; p = 0.040) in the postpartum samples but were not different between the two groups in the 3rd trimester. Women who underwent CS had a lower rate of increase in adiponectin concentration from the 3rd trimester to 30-45 days postpartum compared to those who underwent VD (β = -.15, 95% CI: -.28-.02, p = 0.030).
  
  
  CONCLUSIONS
  The CS procedure was associated with lower maternal circulating concentrations of adiponectin at 30-45 days postpartum, compared to the VD.
authors.affiliation: National School of Public Health, Oswaldo Cruz Foundation, Rio de Janeiro, RJ, Brazil.|Nutritional Epidemiology Observatory, Department of Social and Applied Nutrition, Institute of Nutrition Josué de Castro, Rio de Janeiro Federal University, Rio de Janeiro, RJ, Brazil.
authors.forename: Fernanda
authors.initials: F
authors.lastname: Rebelo
authors.affiliation: Nutritional Epidemiology Observatory, Department of Social and Applied Nutrition, Institute of Nutrition Josué de Castro, Rio de Janeiro Federal University, Rio de Janeiro, RJ, Brazil.
authors.forename: Ana Beatriz
authors.initials: AB
authors.lastname: Franco-Sena
authors.affiliation: National School of Public Health, Oswaldo Cruz Foundation, Rio de Janeiro, RJ, Brazil.
authors.forename: Claudio Jose
authors.initials: CJ
authors.lastname: Struchiner
authors.affiliation: Nutritional Epidemiology Observatory, Department of Social and Applied Nutrition, Institute of Nutrition Josué de Castro, Rio de Janeiro Federal University, Rio de Janeiro, RJ, Brazil.
authors.forename: Gilberto
authors.initials: G
authors.lastname: Kac
mesh_terms: D052242:Adiponectin / Q000097:blood*; D000328:Adult; D002585:Cesarean Section; D005260:Female; D006801:Humans; D050498:Live Birth; D049590:Postpartum Period / Q000097:blood*; D011247:Pregnancy / Q000097:blood*; D011446:Prospective Studies
chemical_list: C499918:ADIPOQ protein, human; D052242:Adiponectin