Long-term health consequences of birth by cesarean section

剖腹产分娩的长期健康后果

基本信息

批准号：
10223391
负责人：
Jorge Eduardo Chavarro
金额：
$ 63.08万
依托单位：
HARVARD SCHOOL OF PUBLIC HEALTH
依托单位国家：
美国
项目类别：
财政年份：
2018
资助国家：
美国
起止时间：
2018-09-01 至 2023-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10223391
关键词：
Address Adipose tissue Adolescence Adolescent and Young Adult Adult Age Asthma Biological Biological Markers Birth Body Composition Body mass index Breast Breast Cancer Risk Factor Cardiovascular Diseases Cardiovascular system Cesarean section Child Childhood Cholesterol Chronic Chronic Disease Colorectal DNA Methylation Data Dual-Energy X-Ray Absorptiometry Enrollment Evaluation Fatty acid glycerol esters Fetus Frequencies Glucose Health High Density Lipoprotein Cholesterol IGFBP3 gene Immune Individual Infant Inflammation Insulin Insulin Resistance Insulin-Like Growth Factor I Interleukin-6 Intervention Knowledge Leptin Life Link Malignant Neoplasms Maternal Mortality Measures Mediating Medical Morbidity - disease rate Mothers Newborn Infant Non-Insulin-Dependent Diabetes Mellitus Obesity Outcome Pattern Perinatal mortality demographics Pregnancy Pregnant Women Premature Mortality Professional Organizations Prostate Puberty Public Health Resources Risk Risk Factors Savings Stimulation of Cell Proliferation Triglycerides Umbilical Cord Blood United States Vagina Vaginal delivery procedure Vitamin D Woman Work abdominal fat adipokines adiponectin adult obesity antenatal blood lipid cancer biomarkers cancer risk cardiometabolic risk cohort cost disorder risk experience genome-wide glucose metabolism gut microbiome gut microbiota high risk inflammatory marker insight interest lipid metabolism maternal morbidity maternal risk methylation pattern microbiota profiles mortality obesity in children obesity risk offspring perinatal morbidity peripheral blood randomized trial recruit respiratory sex stool sample whole genome

项目摘要

ABSTRACT Nearly 1.3 million cesareans are performed each year, resulting in the birth of one third of all children nationwide. When indicated, cesarean sections reduce morbidity and mortality to mother and fetus. However, many cesareans do not have a clear medical indication leading to an increase in serious maternal and perinatal morbidity and mortality. Increasing evidence also suggests that risks to offspring may extend to chronic-non communicable conditions. Consistent evidence shows that individuals born by cesarean are at an increased risk of obesity as children and that higher rates of obesity persist through adult life, raising the possibility that the long-term health consequences of being born by cesarean may extend to an increased risk of obesity-related chronic conditions including common cancers (breast, prostate, colorectal), cardiovascular disease and type 2 diabetes. However, data on the association of birth by cesarean with risk factors for or biomarkers of chronic disease risk remains scarce. There is also a paucity of information regarding the biologic mechanisms underlying the relation between cesarean delivery and offspring chronic disease risk. This proposal addresses these knowledge gaps. Specifically, we propose to evaluate the relation of birth by cesarean with pubertal onset –an established risk factor for breast cancer; with longitudinal trajectories in biomarkers of chronic disease risk –including markers of mitogenesis, inflammation, insulin resistance, lipid metabolism and adipose tissue activity; and with longitudinal trajectories in body composition (Aims 1 and 2). In addition, we propose to evaluate the relation of birth by cesarean section with longitudinal trajectories in whole genome DNA methylation patterns and gut microbiome (Aims 3 and 4) in order to gain further understanding on the biological underpinnings of the long-term health consequences of birth by cesarean.

抽象的每年有近 130 万例剖腹产手术，导致三分之一的婴儿出生在全国范围内，剖腹产可降低母亲和胎儿的发病率和死亡率。许多剖腹产手术没有明确的医学指征，导致严重孕产妇和产妇死亡人数增加。越来越多的证据还表明，对后代的风险可能会扩大到。一致的证据表明，剖腹产出生的人处于慢性非传染性疾病的状态。儿童时期肥胖的风险增加，并且成年后肥胖率持续升高，从而提高了剖腹产对健康的长期影响可能会增加风险与肥胖相关的慢性疾病，包括常见癌症（乳腺癌、前列腺癌、结直肠癌）、心血管疾病然而，剖腹产与 2 型糖尿病的危险因素相关的数据。慢性病风险的生物标志物仍然稀缺，有关生物制剂的信息也很少。剖宫产与后代慢性病风险之间关系的潜在机制。具体来说，我们建议通过以下方式评估出生关系。青春期发病的剖宫产——乳腺癌的既定危险因素；慢性病风险的生物标志物——包括有丝分裂、炎症、胰岛素抵抗、脂质标志物新陈代谢和脂肪组织活动；以及身体成分的纵向轨迹（目标 1 和 2）。此外，我们建议评估剖宫产分娩与纵向轨迹的关系全基因组 DNA 甲基化模式和肠道微生物组（目标 3 和 4），以便进一步获得了解剖腹产对健康的长期影响的生物学基础。