Background: Caesarean section rates have increased in parallel with those of obesity. Decreased levels of adiponectin, an adipocyte-derived metabolic hormone present in abundant concentrations in cord blood and breast milk, have been documented in association with obesity in children and adults. Objective: To determine whether the mode of delivery affects adiponectin concentrations in cord blood of healthy term infants. Methods: The cord blood adiponectin concentration was measured in 159 consecutive term infants, of whom 131 (82.4%) were born by vaginal delivery, 15 (9.4%) by nonelective caesarean section and 13 (8.2%) by elective caesarean section. Results: The mean adiponectin level was significantly lower in infants born by elective caesarean section compared with those born by vaginal delivery: 15.3 µg/ml (SD = 6.8) and 21.6 µg/ml (SD = 7.3), respectively (p = 0.015). This difference remained significant after adjustment for the infants' gender and birth weight as well as maternal weight and weight gain during pregnancy. Conclusion: Elective caesarean section may carry a risk of obesity independently of maternal risk factors.

Keywords:
Mode of delivery, Caesarean section, Adiponectin
1.
Betrán AP, Merialdi M, Lauer JA, Bing-Shun W, Thomas J, Van Look P, Wagner M: Rates of caesarean section: analysis of global, regional and national estimates. Paediatr Perinat Epidemiol 2007;21:98-113.
2.
Hyde MJ, Modi N: The long-term effects of birth by caesarean section: the case for randomized controlled trial. Early Hum Dev 2012;88:943-949.
3.
Huh S, Rifas-Shiman S, Zera C, Edwards J, Oken E, Weiss S, Gillman M: Delivery by caesarean section and risk of obesity in preschool age children: a prospective cohort study. Arch Dis Child 2012;97:610-616.
4.
Whitehead JP, Richards AA, Hickman IJ, Macdonald GA, Prins JB: Adiponectin - a key adipokine in the metabolic syndrome. Diabetes Obes Metab 2006;8:264-280.
5.
Tsai JP, Yu CH, Hsu SP, Lee YH, Chiou CH, Hsu YW, Ho JC, Chu CH: Cord plasma adiponectin concentrations of adiponectin and leptin in healthy term neonates: positive correlation between birthweight and neonatal adiposity. Clin Endocrinol (Oxf) 2004;61:88-93.
6.
Aaltonen J, Ojala T, Laitinen K, Poussa T, Ozanne S, Isolauri E: Impact of maternal diet during pregnancy and breastfeeding on infant metabolic programming: a prospective randomized controlled study. Eur J Clin Nutr 2011;65:10-19.
7.
Li HT, Zhou YB, Liu JM: The impact of caesarean section on offspring overweight and obesity: a systematic review and meta-analysis. Int J Obes (Lond) 2013;37:893-899.
8.
Rautava S, Luoto R, Salminen S, Isolauri E: Microbial contact during pregnancy, intestinal colonization and human disease. Nat Rev Gastroenterol Hepatol 2012;9:565-576.
9.
Chiesa C, Osborn JF, Haass C, Natale F, Spinelli M, Scapillati E, Spinelli A, Pacifico L: Ghrelin, Leptin, IGF-1, IGFBP-3 and insulin concentrations at birth: is there a relationship with fetal growth and neonatal anthropometry? Clin Chem 2008;54:550-558.
10.
Woo J, Guerrero L, Guo F, Martin L, Davidson B, Ortega H, Ruiz-Palacios G, Morrow A: Human milk adiponectin affects infant weight trajectory during the second year of life. J Pediatr Gastroenterol Nutr 2012;54:532-539.
© 2014 S. Karger AG, Basel
2014
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.