The association between birth by cesarean section and adolescent cardiorespiratory fitness in a cohort of 339,451 Swedish males

Abstract Birth by cesarean section is increasing worldwide and associates with offspring morbidities capable of adversely impacting cardiorespiratory fitness later in life. Whether birth by cesarean section associates with lower levels of cardiorespiratory fitness later in life is unknown and is of...

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Autores principales:	Lucas D. Ekstrom, Viktor H. Ahlqvist, Margareta Persson, Cecilia Magnusson, Daniel Berglind
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2020
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/21e397f28e3748bfaaf4eec93701797e
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spelling	oai:doaj.org-article:21e397f28e3748bfaaf4eec93701797e2021-12-02T15:10:06ZThe association between birth by cesarean section and adolescent cardiorespiratory fitness in a cohort of 339,451 Swedish males10.1038/s41598-020-75775-22045-2322https://doaj.org/article/21e397f28e3748bfaaf4eec93701797e2020-10-01T00:00:00Zhttps://doi.org/10.1038/s41598-020-75775-2https://doaj.org/toc/2045-2322Abstract Birth by cesarean section is increasing worldwide and associates with offspring morbidities capable of adversely impacting cardiorespiratory fitness later in life. Whether birth by cesarean section associates with lower levels of cardiorespiratory fitness later in life is unknown and is of interest to public health. Four Swedish national registers were linked to follow 339,451 singleton males, born between 1973–1987 until December 31 2005, for Watt-maximum achieved on a cycle ergometer test at conscription into the Swedish military. Main exposure was birth by cesarean section which was compared to vaginal birth. A sub-population of 45,999 males born between 1982–1987 was identified to explore differentiated associations between elective and non-elective cesarean section with Watt-maximum. Within-family analyses of 34,252 families with 70,632 biological male siblings, who conscripted during the study period, were performed to explore the role of familial confounding on Watt-maximum. Swedish males born by cesarean section achieved lower mean Watt-maximum (− 2.32 W, 95%C.I. − 2.90 to − 1.75) and displayed excess odds of low cardiorespiratory fitness (aOR = 1.08, 95%C.I. 1.05 to 1.11) at conscription in the eighteenth life-year compared to males born vaginally after adjusting for birth characteristics, maternal morbidities and parental socioeconomic position. In the sub-population, males born 1982–1987, there was a greater negative association of elective cesarean section with cardiorespiratory fitness (− 4.42 W, 95%C.I. − 6.27 to − 2.57, p < 0.001) than non-elective cesarean sections (− 1.96 W, 95%C.I. − 3.77 to − 0.16, p = 0.033) as compared to vaginal births. No associations between modes of cesarean delivery and cardiorespiratory fitness levels persisted in the within-family analyses where biological male siblings were compared whilst controlling for factors shared within families. Males born by cesarean section had lower levels of cardiorespiratory fitness eighteen years later compared to males born vaginally. These findings appear to be largely explained by factors of familial confounding.Lucas D. EkstromViktor H. AhlqvistMargareta PerssonCecilia MagnussonDaniel BerglindNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 10, Iss 1, Pp 1-10 (2020)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Lucas D. Ekstrom Viktor H. Ahlqvist Margareta Persson Cecilia Magnusson Daniel Berglind The association between birth by cesarean section and adolescent cardiorespiratory fitness in a cohort of 339,451 Swedish males
description	Abstract Birth by cesarean section is increasing worldwide and associates with offspring morbidities capable of adversely impacting cardiorespiratory fitness later in life. Whether birth by cesarean section associates with lower levels of cardiorespiratory fitness later in life is unknown and is of interest to public health. Four Swedish national registers were linked to follow 339,451 singleton males, born between 1973–1987 until December 31 2005, for Watt-maximum achieved on a cycle ergometer test at conscription into the Swedish military. Main exposure was birth by cesarean section which was compared to vaginal birth. A sub-population of 45,999 males born between 1982–1987 was identified to explore differentiated associations between elective and non-elective cesarean section with Watt-maximum. Within-family analyses of 34,252 families with 70,632 biological male siblings, who conscripted during the study period, were performed to explore the role of familial confounding on Watt-maximum. Swedish males born by cesarean section achieved lower mean Watt-maximum (− 2.32 W, 95%C.I. − 2.90 to − 1.75) and displayed excess odds of low cardiorespiratory fitness (aOR = 1.08, 95%C.I. 1.05 to 1.11) at conscription in the eighteenth life-year compared to males born vaginally after adjusting for birth characteristics, maternal morbidities and parental socioeconomic position. In the sub-population, males born 1982–1987, there was a greater negative association of elective cesarean section with cardiorespiratory fitness (− 4.42 W, 95%C.I. − 6.27 to − 2.57, p < 0.001) than non-elective cesarean sections (− 1.96 W, 95%C.I. − 3.77 to − 0.16, p = 0.033) as compared to vaginal births. No associations between modes of cesarean delivery and cardiorespiratory fitness levels persisted in the within-family analyses where biological male siblings were compared whilst controlling for factors shared within families. Males born by cesarean section had lower levels of cardiorespiratory fitness eighteen years later compared to males born vaginally. These findings appear to be largely explained by factors of familial confounding.
format	article
author	Lucas D. Ekstrom Viktor H. Ahlqvist Margareta Persson Cecilia Magnusson Daniel Berglind
author_facet	Lucas D. Ekstrom Viktor H. Ahlqvist Margareta Persson Cecilia Magnusson Daniel Berglind
author_sort	Lucas D. Ekstrom
title	The association between birth by cesarean section and adolescent cardiorespiratory fitness in a cohort of 339,451 Swedish males
title_short	The association between birth by cesarean section and adolescent cardiorespiratory fitness in a cohort of 339,451 Swedish males
title_full	The association between birth by cesarean section and adolescent cardiorespiratory fitness in a cohort of 339,451 Swedish males
title_fullStr	The association between birth by cesarean section and adolescent cardiorespiratory fitness in a cohort of 339,451 Swedish males
title_full_unstemmed	The association between birth by cesarean section and adolescent cardiorespiratory fitness in a cohort of 339,451 Swedish males
title_sort	association between birth by cesarean section and adolescent cardiorespiratory fitness in a cohort of 339,451 swedish males
publisher	Nature Portfolio
publishDate	2020
url	https://doaj.org/article/21e397f28e3748bfaaf4eec93701797e
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The association between birth by cesarean section and adolescent cardiorespiratory fitness in a cohort of 339,451 Swedish males

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