Delivery Mode, Duration of Labor, and Cord Blood Adiponectin, Leptin, and C-Reactive Protein: Results of the Population-Based Ulm Birth Cohort Studies

Abstract

BackgroundNumerous studies have reported associations between delivery mode and health outcomes in infancy and later life. Previous smaller studies indicated a relationship between delivery mode and newborn inflammation potentially constituting a mediating factor. We aimed to determine the influence of delivery mode and duration of labor on cord blood concentrations of adiponectin, leptin, and high-sensitivity C-reactive protein (hs-CRP).MethodsIn the Ulm SPATZ Health Study, 934 singleton newborns and their mothers were recruited during their hospital stay in the University Medical Center Ulm, Southern Germany, from 04/2012-05/2013. Inflammatory biomarkers were measured by ELISAs (n = 836). Delivery mode was analyzed categorically (elective cesarean (reference), active labor delivery: emergency cesarean, assisted vaginal, and spontaneous vaginal); duration of labor continuously. Following log-transformation, linear regression was used to estimate geometric means ratios (GMR) adjusted for potential confounders for the effects of delivery mode and duration of labor on each biomarker separately. Independent replication was sought in the similarly conducted Ulm Birth Cohort Study recruited from 11/2000-11/2001.ResultsIndividually, active labor delivery modes as well as increasing duration of labor were associated with higher leptin and hs-CRP concentrations. After mutual adjustment, the associations with delivery modes were attenuated but those for duration of labor remained statistically significant (GMR (95%CI) 1.10 (1.00; 1.21) and 1.15 (1.04; 1.27) for leptin and hs-CRP per hour of labor, respectively). No significant adjusted associations were observed between delivery modes and adiponectin concentrations. These findings were replicated in an independent birth cohort study.ConclusionsCord blood leptin and hs-CRP concentrations were associated with duration of labor rather than delivery mode. Further research is warranted to investigate these associations with additional cytokines involved in inflammatory response to delineate the inflammatory profile. Subsequently, research on determinants of these associations and their role in development of chronic disease is needed.

Soluble CD14 concentration in human breast milk and its potential role in child atopic dermatitis: Results of the Ulm Birth Cohort Studies

“…16,20,21 In brief, SPATZ mothers were older, more educated, more often born in Germany, had lower prevalence of smoking and higher prevalence of obesity when compared to UBCS mothers (Table S1). 16,20,21 In brief, SPATZ mothers were older, more educated, more often born in Germany, had lower prevalence of smoking and higher prevalence of obesity when compared to UBCS mothers (Table S1).…”

“…Details can be found elsewhere. 13,16 Exclusion criteria were outpatient delivery, maternal age <18 years, transfer of the newborn or the mother to intensive care immediately after delivery, and/or insufficient knowledge of the…”

Preventing Cesarean Birth in Women with Obesity: Influence of Unit‐Level Midwifery Presence on Use of Cesarean among Women in the Consortium on Safe Labor Data Set

“…6,7 There are several pathophysiologic shifts, including increased plasma leptin and cholesterol, lipotoxicity, and ectopic fat accumulation in myometrial cells, that are related to maternal obesity and may cause functional impairments in the ability of myometrial cells to contract regularly or forcefully. 17,18,[44][45][46] Most of these changes occur more severely with increasing maternal BMI.…”

Serum adiponectin concentration in healthy, eutrophic full-term neonates born by cesarean section

“…Jedynymi dotychczas publikowanymi wynikami badań wpływu porodu zabiegowego (cięcie cesarskie planowe i nagłe) na stężenia adiponektyny u noworodków są badania Logana i wsp. [24]. Nie wykazały one jednak istotnego wpływu tego typu porodu zabiegowego na stężenie adiponektyny w krwi pępowinowej u zdrowych noworodków.…”

“…Jedynie Logan i wsp. ocenili stężenie adiponektyny w krwi pępo-winowej noworodków urodzonych cięciem cesarskim [24]. Autorzy jednak nie analizowali wskazań do tego porodu zabiegowego (czy był on planowy czy wykonany w stanie zagrożenia zdrowia lub życia matki lub noworodka, czyli z nagłych wskazań).…”