Abstract
A number of studies have shown that children born by cesarean section have lower blood pressure during the neonatal period. The aim of this study was to investigate whether mode of delivery influenced childhood blood pressure: at age 7.5 to 8 y in a cohort of 756 children born preterm, at 7 to 9 y in a pilot study of 166 children born at term in the United Kingdom, and in a cohort of 650 Tasmanian children born at term. In the preterm cohort, systolic blood pressure was significantly lower in children born by cesarean section rather than delivered vaginally (99.3 ± 10.0 versus 101.4 ± 9.4 mm Hg; 95% confidence interval, −0.69 to −3.46;p = 0.003), with a significant trend to having a higher pressure in those born by breech versus forceps versus spontaneous vaginal delivery versus cesarean section. These findings were not replicated in the term cohorts. This raises the hypothesis that there is a sensitive period for programming later blood pressure by factors associated with mode of delivery and that this period does not extend to full-term.
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Abbreviations
- CI:
-
confidence interval
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Acknowledgements
The authors thank Dr. Catherine Leeson-Payne and Dr. Gill Lister for measuring blood pressure in children from the preterm cohort in the United Kingdom, and Dr. Anne-Louise Ponsonby, who made a major contribution to the Tasmanian Infant Health Survey, as well as the nurses who measured blood pressures in Tasmania. We especially thank the children taking part in these studies, their families, and the schools who provided facilities.
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The preterm study was funded by Farley Health Products (a division of HJ Heinz & Co Ltd). The Tasmanian cohort study was funded by the US National Institutes of Health (grant HD28979–01A1), Tasmanian State Government, Australian Rotary Health Research Fund, National Health and Medical Research Council of Australia, Sudden Infant Death Syndrome Research Foundation, National Sudden Infant Death Syndrome Council of Australia, Community Organisations' support program of the Department of Human Services and Health, Zonta International, Wyeth Pharmaceuticals, and Tasmanian Sanatoria After-Care Association.
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Morley, R., Kennedy, K., Lucas, A. et al. Mode of Delivery and Childhood Blood Pressure. Pediatr Res 47, 463–467 (2000). https://doi.org/10.1203/00006450-200004000-00009
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DOI: https://doi.org/10.1203/00006450-200004000-00009
