Cardiovascular System Features of Young Adults Born with Cesarean Section

Year 2020, Volume: 8 Issue: 2, 124 - 130, 23.08.2020

Ercan Akşit , Emine Gazi , Bahadır Kırılmaz , Melike Edinciklioğlu Hasan Bozkurt Özge Turgay Yıldırım , Fatih Aydın

https://doi.org/10.37696/nkmj.730698

Abstract

Aim: Currently, the prevalence of caesarean section (CS) has been increasing at an alarming rate across the world. In parallel with the increasing rate of CS, it is reported that there is an increasing prevalence of obesity, autoimmune and allergic diseases. The purpose of the present study is to analyse whether the cardiovascular system characteristics of young adults born by CS are different from those of young adults born by vaginal delivery (VD).
Materials and Methods: A total of 112 participants were included in the study (40 CS group vs 82 VD ie control group). Transthoracic echocardiography and carotid Doppler ultrasonography were performed to the participants. In addition, participants were evaluated with a 24-hour ECG recording.
Results: Tricuspid E wave, tricuspid A wave and tricuspid E/A ratio were lower in the CS group compared with the control group (57.6±8.6 vs. 72.4±10.3, p<0.001; 46.7±8.8 vs. 50.6±8.9, p=0.04 ; 1.2±0.14 vs 1.45±0.88, p<0.001). Epicardial fat tissue thickness were higher in the CS group compared with the control group (4.8±1.3 vs. 3.1±0.8, p<0.001).
Conclusion: The results of this study show that cardiovascular system features of the young adults born with CS are different from those born with VD. Further follow-up studies are needed to understand whether these findings will subsequently result in cardiovascular diseases.

Keywords

epicardial fat tissue, intima media thickness, heart rate variability, cesarean section

Supporting Institution

yok

Project Number

-

Thanks

-

Sezaryen ile Doğmuş Genç Erişkinlerin Kardiyovasküler Sistem Özellikleri

Abstract

Amaç: Günümüzde sezaryen ile doğum (SD) sıklığı dünya genelinde alarm veren düzeyde artmaktadır. Sezaryen sıklığının artmasına parelel olarak obezite, otoimmün ve alerjik hastalıkların yaygınlığının arttığı bildirilmektedir. Bu çalışmanın amacı, SD’li genç erişkinlerin kardiyovasküler sistem özelliklerinin, vajinal yolla doğmuş (VD) genç erişkinlerden farklı olup olmadığını analiz etmektir.
Materyal ve Metot: Çalışmaya toplam 112 katılımcı dahil edildi (40 SD grubu ve 82 VD yani kontrol grubu). Katılımcılara transtorasik ekokardiyografi ve karotis Doppler ultrasonografi yapıldı. Ayrıca, katılımcılar 24 saatlik EKG kaydı ile değerlendirildi.
Bulgular: Triküspit E dalgası, triküspit A dalgası ve triküspit E/A oranı sezaryen grubunda kontrol grubuna göre daha düşüktü (57.6±8.6 ve 72.4±10.3, p<0.001; 46.7±8.8 ve 50.6±8.9, p=0.04 ; 1.2±0.14 ve 1.45±0.88, p<0.001). Epikardiyal yağ doku kalınlığı sezaryen grubunda kontrol grubuna göre daha yüksekti (4.8±1.3 ve 3.1±0.8, p<0.001).
Sonuç: Bu çalışmanın sonuçları, CS ile doğan genç erişkinlerin kardiyovasküler sistem özelliklerinin VD ile doğanlardan farklı olduğunu göstermektedir. Bu bulguların daha sonra kardiyovasküler hastalıklara yol açıp açmayacağını anlamak için daha ileri takip çalışmalarına ihtiyaç vardır.
Anahtar kelimeler: epikardiyal yağ dokusu, intima media kalınlığı, kalp hızı değişkenliği, sezaryen doğum

Keywords

epikardiyal yağ dokusu, intima media kalınlığı, kalp hızı değişkenliği, sezaryen doğum

Project Number

-

References

• 1. Coates D, Homer C, Wilson A, Deady L, Mason E, Foureur M, et al. Indications for, and timing of, planned caesarean section: Systematic analysis of guidelines. Women Birth. 2020;33:22-34.
• 2. Betran AP, Torloni MR, Zhang JJ, Gulmezoglu AM. WHO Working Group on Caesarean Section. WHO Statement on Caesarean Section Rates. BJOG. 2016;123(5):667-70.
• 3. Wise J. Alarming global rise in caesarean births, figures show. BMJ. 2018;363:k4319.
• 4. Wang L, Alamian A, Southerland J, Wang K, Anderson J, Stevens M. Cesarean section and the risk of overweight in grade 6 children. Eur J Pediatr. 2013;172:1341-7.
• 5. Neu J, Rushing J. Cesarean versus vaginal delivery: long-term infant outcomes and the hygiene hypothesis. Clin Perinatol. 2011;38:321-31.
• 6. Ley RE, Turnbaugh PJ, Klein S, Gordon JI. Microbial ecology: human gut microbes associated with obesity. Nature. 2006;444:1022-3.
• 7. Okada H, Kuhn C, Feillet H, Bach JF. The ‘hygiene hypothesis’ for autoimmune and allergic diseases:an update. Clin Exp Immunol. 2010;160(1):1-9.
• 8. Jin M, Qian Z, Yin J, Xu W, Zhou X. The role of intestinal microbiota in cardiovascular disease. J Cell Mol Med. 2019;23(4):2343-50.
• 9. Iacobellis G, Willens HJ. Echocardiographic epicardial fat: a review of research and clinical applications. J Am Soc Echocardiogr. 2009;22(12):1311-9.
• 10. Evensen K, Dahl A, Ronning OM, Russell D. The assessment of carotid atherosclerosis using a new multipurpose ultrasound probe. J Neuroimaging. 2015;25:232-7.
• 11. Billman GE, Huikuri HV, Sacha J, Trimmel K. An introduction to heart rate variability: methodological considerations and clinical applications. Front Physiol. 2015;6:55.
• 12. Goldani HA, Bettiol H, Barbieri MA, Silva AAM, Agranonik M, Morais MB, et al. Cesarean delivery is associated with an increased risk of obesity in adulthood in a Brazilian birth cohort study. Am J Clin Nutr. 2011;93:1344-47.
• 13. Svensson E, Hyde M, Modi N, Ehrenstein V. Caesarean section and body mass index among danish men. Obesity. 2013;21(3):429-33.
• 14. Zhou YB, Li HT, Si KY, Zhang YL, Wang LL, Liu JM. Association of elective cesarean delivery with metabolic measures in childhood: A prospective cohort study in China. Nutr Metab Cardiovasc Dis. 2019;29:775-82.
• 15. Cardwell CR, Stene LC, Joner G, Cinek O, Svensson J, Goldacre MJ, et al. Caesarean section is associated with an increased risk of childhood-onset type 1 diabetes mellitus: A meta-analysis of observational studies. Diabetologia. 2008;51:726-35.
• 16. Biasucci G, Benenati B, Morelli L, Bessi E, Boehm G. Cesarean delivery may affect the early biodiversity of intestinal bacteria. J Nutr. 2008:138;1796-800.
• 17. Cavallini DU, Suzuki JY, Abdalla DP, Vendramini RC, Pauly-Silveira ND, Roselino MN, et al. Influence of a probiotic soy product on fecal microbiota and its association with cardiovascular risk factors in an animal model. Lipids Health Dis. 2011:10;126.
• 18. Kalliomäki M, Collado MC, Salminen S, Isolauri E. Early differences in fecal microbiota composition in children may predict overweight. Am J Clin Nutr. 2008:87;534-8.
• 19. Kuitunen M, Kukkonen K, Juntunen-Backman K, Korpela R, Poussa T, Tuure T, et al. Probiotics prevent IgE-associated allergy until age 5 years in Cesarean-delivered children but not in the total cohort. J Allergy Clin Immunol. 2009:123;335-41.
• 20. Shedeed SA. Right Ventricular Function in Children with Bronchial Asthma: A Tissue Doppler Echocardiographic Study. Pediatr Cardiol. 2010;31:1008-15.
• 21. Rexhepaj N, Bajraktari G, Berisha I, Beqiri A, Shatri F, Hima F, et al. Left and right ventricular diastolic functions in patients with rheumatoid arthritis without clinically evident cardiovascular disease. Int J Clin Pract. 2006;60(6):683-8.
• 22. Li HT, Trasande L, Zhu LP, Ye RW, Zhou YB, Liu JM. Association of cesarean delivery with anemia in infants and children in 2 large longitudinal Chinese birth cohorts. Am J Clin Nutr. 2015;101:523-9.
• 23. Vida G, Sulyok E, Ertl T, Lobenhoffer JM, Bode-Böger SM. Birth by cesarean section is associated with elevated neonatal plasma levels of dimethylarginines. Pediatr Int. 2012;54:476-9.
• 24. Halcox JP, Donald AE, Ellins E, Witte DR, Shipley MJ, Brunner EJ, et al. Endothelial function predicts progression of carotid intima-media thickness. Circulation. 2009;119:1105-12.
• 25. Kozar M, Tonhajzerova I, Mestanik M, Matasova K, Zibolen M, Calkovska A, et al. Heart rate variability in healthy term newborns is related to delivery mode: a prospective observational study. BMC Pregnancy and Childbirth. 2018;18(1):264.