Cesarean Delivery and Hypertension in Early Adulthood

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art_FERRARO_Cesarean_Delivery_and_Hypertension_in_Early_Adulthood_2019.PDF (222.22 KB)
Citações na Scopus
10
Tipo de produção
article
Data de publicação
2019
DOI
Scopus
Web of Science
PubMed
Título da Revista
ISSN da Revista
Título do Volume
Editora
OXFORD UNIV PRESS INC
Autores
BARBIERI, Marco Antonio
SILVA, Antonio Augusto Moura da
GOLDANI, Marcelo Zubaran
CARDOSO, Viviane Cunha
STEIN, Aryeh David
BETTIOL, Heloisa
Citação
AMERICAN JOURNAL OF EPIDEMIOLOGY, v.188, n.7, p.1296-1303, 2019
Projetos de Pesquisa
Unidades Organizacionais
Fascículo
Resumo
The rate of cesarean delivery (CD) is high in many parts of the world. Birth via CD has been associated with adverse later health outcomes, such as obesity, asthma, and type 1 diabetes mellitus. Few studies have focused on hypertension. We investigated the associations of CD with hypertension, systolic blood pressure (BP), and diastolic BP and tested whether body mass index (BMI; weight (kg)/height (m)(2)) was a mediator of these associations in a birth cohort (n = 2,020) assembled in 1978-1979 and followed up in 2002-2004 in Ribeirao Preto, Brazil. The CD rate was 32.0%. Hypertension was present in 11.7% of persons born via CD and 7.7% of those born vaginally. Being born by CD increased the odds of hypertension by 51% (odds ratio = 1.51, 95% confidence interval (CI): 1.10, 2.07). After adjustment for confounders, this estimate changed little (odds ratio = 1.49, 95% CI: 1.07, 2.06). In a mediation analysis, odds ratios for the indirect and direct effects were 1.18 (95% CI: 1.11, 1.25) and 1.31 (95% CI: 0.97, 1.65), respectively. CD also had indirect effects on both systolic and diastolic BP via BMI. Our findings suggest that CD is associated with young-adult hypertension and that this association is at least partially mediated by BMI. This has implications for countries struggling with the burden of noncommunicable diseases and where CD rates are high.
Palavras-chave
cesarean delivery, hypertension, life cycle
URI
https://observatorio.fm.usp.br/handle/OPI/34491
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Coleções
Artigos e Materiais de Revistas Científicas - FM/MPE
Artigos e Materiais de Revistas Científicas - LIM/21
Artigos e Materiais de Revistas Científicas - ODS/03