Birth mode and infectious morbidity risks in Qom children of Argentina.

Authors:
Melanie A Martin
Melanie A Martin
University of California Santa Barbara
Claudia R Valeggia
Claudia R Valeggia
Harvard University
Cambridge | United States

Am J Hum Biol 2018 Dec 19:e23200. Epub 2018 Dec 19.

Department of Anthropology, Yale University, New Haven, Connecticut.

Objectives: Cesarean delivery may increase childhood infectious morbidity risks via altered birth exposures and subsequent immune, microbial, and epigenetic development. Many Latin American indigenous populations experience dual burdens of infectious and chronic diseases, and are particularly vulnerable to rising rates of cesarean delivery and associated adverse outcomes. The Qom/Toba are an indigenous population in Argentina experiencing rapid lifestyle transitions. We hypothesized that cesarean delivery would be associated with increased risk of infectious symptoms in Qom children after adjusting for gestational and nutritional factors.

Methods: We conducted a secondary analysis of birth records and monthly anthropometric and illness data collected previously from 90 Qom children (aged 1-55 months). We tested for additive effects of birth mode on risk of gastrointestinal (GI) and respiratory illness (RI) in mixed-effects logistic regression models adjusting for child weight-for-age (WAZ), weaning, and gestational and maternal age.

Results: Cesarean deliveries accounted for 46% of births and were associated with maternal age < 20 and ≥ 30 years, gestational age < 39 weeks, and prenatal complications. GI and RI risks were reduced in association with cesarean delivery, greater WAZ, weaning, maternal age ≥ 30 years, and gestational age < 39 weeks.

Conclusions: The relationship between cesarean delivery and reduced infectious risks may reflect statistical confounding with relatively rapid postnatal growth and greater adiposity. Postnatal growth trajectories may be important mediators of long-term morbidity risks associated with cesarean delivery. The frequency of cesarean deliveries among the Qom remains concerning given traditionally high rates of fertility and adolescent pregnancy.

Download full-text PDF

Source
http://dx.doi.org/10.1002/ajhb.23200DOI Listing

Still can't find the full text of the article?

We can help you send a request to the authors directly.
December 2018
12 Reads

Publication Analysis

Top Keywords

qom children
12
cesarean delivery
12
birth mode
8
morbidity risks
8
delivery associated
8
infectious morbidity
8
nutritional factorsmethods
4
factorsmethods conducted
4
gestational nutritional
4
children adjusting
4
symptoms qom
4
conducted secondary
4
adjusting gestational
4
analysis birth
4
anthropometric illness
4
illness data
4
monthly anthropometric
4
records monthly
4
infectious symptoms
4
birth records
4

References

(Supplied by CrossRef)
Growth patterns among indigenous Qom children of the argentine Gran Chaco
Alfonso-Durruty et al.
American Journal of Human Biology 2016
Fitting linear mixed-effects models using lme4
Bates et al.
Journal of Statistical Software 2014
Rates and implications of caesarean sections in Latin America: Ecological study
Belizán et al.
BMJ 1999
Growth references for Tsimane forager-horticulturalists of the Bolivian Amazon
Blackwell et al.
American Journal of Physical Anthropology 2017
Time to consider the risks of caesarean delivery for long term child health
Blustein et al.
BMJ 2015

Similar Publications