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Maternal obesity and cesarean section delivery: additional risk factors for neonatal hypoglycemia?

ABSTRACT: OBJECTIVES:To determine (1) whether higher maternal body mass index (BMI) and Cesarean (C) Section mode of delivery are associated with neonatal hypoglycemia (NH) and (2) whether timing of NH onset differs by risk factors. STUDY DESIGN:Retrospective cohort study (n?=?4602) to determine the odds of NH, NH requiring IV dextrose and timing of NH onset among infants with established and plausible (BMI and C-section) risk factors. RESULT:Infants born to class III obese mothers had higher odds of NH (OR 1.3, 95% CI 1.0-1.8) and of requiring IV dextrose (OR 2.2, 95% CI 1.2-3.9). Infants born via C-section had higher odds of requiring IV dextrose (OR 1.4, 95% CI 1.1-1.9). Infants who were delivered to high BMI mothers and by C-section developed NH earlier than the reference group. CONCLUSION:Determining the predictors and timing of NH onset may help develop tailored evaluation and management strategies for at-risk neonates.

SUBMITTER: Turner D

PROVIDER: S-EPMC6660417 | biostudies-literature | 2019 Aug

REPOSITORIES: biostudies-literature

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Maternal obesity and cesarean section delivery: additional risk factors for neonatal hypoglycemia?

Turner Daria D Monthé-Drèze Carmen C Cherkerzian Sara S Gregory Katherine K Sen Sarbattama S

Journal of perinatology : official journal of the California Perinatal Association 20190618 8

<h4>Objectives</h4>To determine (1) whether higher maternal body mass index (BMI) and Cesarean (C) Section mode of delivery are associated with neonatal hypoglycemia (NH) and (2) whether timing of NH onset differs by risk factors.<h4>Study design</h4>Retrospective cohort study (n = 4602) to determine the odds of NH, NH requiring IV dextrose and timing of NH onset among infants with established and plausible (BMI and C-section) risk factors.<h4>Result</h4>Infants born to class III obese mothers h ...[more]

PMID: 31213637

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Project description:IntroductionChanges within the maternal microbiome during the last trimester of pregnancy and the determinants of the subsequent neonatal microbiome establishment after delivery by elective cesarean section are described.Material and methodsMaternal vaginal and rectal microbiome samples were collected in the last trimester and before cesarean section; intrauterine cavity, placenta, neonatal buccal mucosa, skin, and meconium samples were obtained at birth; neonatal sample collection was repeated 2-3 days postnatally. Microbial community composition was analyzed by 16S rRNA gene amplicon sequencing. Relative abundance measurements of amplicon sequencing variants and sum counts at higher taxonomic levels were compared to test for significant overlap or differences in microbial community compositions.Clinicaltrialsgov ID: NCT04489056.ResultsA total of 30 mothers and their neonates were included with available microbiome samples for all maternal, intrauterine cavity and placenta samples, as well as for 18 of 30 neonates. The composition of maternal vaginal and rectal microbiomes during the last trimester of healthy pregnancies did not significantly change (permutational multivariate analysis of variance [PERMANOVA], p > 0.05). No robust microbial signature was detected in the intrauterine cavity, placenta, neonatal buccal mucosa, skin swabs, or meconium samples collected at birth. After birth, the neonatal microbiome was rapidly established, and significantly different microbial communities were detectable 2-3 days postnatally in neonate buccal mucosa and stool samples (PERMANOVA, p < 0.01).ConclusionsMaternal vaginal and rectal microbiomes in healthy pregnancies remain stable during the third trimester. No microbial colonization of the neonate was observed before birth in healthy pregnancies. Neonatal microbiomes in infants delivered by cesarean section displayed a taxonomic composition distinct from maternal vaginal and rectal microbiomes at birth, indicating that postnatal exposure to the extrauterine environment is the driving source of initial neonatal microbiome development in this cohort.

Dataset Information

Maternal obesity and cesarean section delivery: additional risk factors for neonatal hypoglycemia?

Publications

Maternal obesity and cesarean section delivery: additional risk factors for neonatal hypoglycemia?

Similar Datasets

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