{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T22:33:02Z","timestamp":1762036382137,"version":"build-2065373602"},"reference-count":51,"publisher":"Springer Science and Business Media LLC","issue":"6","license":[{"start":{"date-parts":[[2021,3,2]],"date-time":"2021-03-02T00:00:00Z","timestamp":1614643200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,3,2]],"date-time":"2021-03-02T00:00:00Z","timestamp":1614643200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Pediatr Res"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Cesarean section (C-section) delivered infants are more likely to be colonized by opportunistic pathogens, resulting in altered growth. We examined whether C-section (elective\/emergency) vs vaginal delivery was associated with altered weight and linear growth at 1 year of life.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>A total of 638 mother\u2013infant pairs were included from MAASTHI cohort 2016\u20132019. Information on delivery mode was obtained from medical records. Based on WHO child growth standards, body mass index-forage <jats:italic>z<\/jats:italic>-score (BMI <jats:italic>z<\/jats:italic>) and length-for-age <jats:italic>z<\/jats:italic>-score (length <jats:italic>z<\/jats:italic>) were derived. We ran multivariable linear and Poisson regression models before and after multiple imputation.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>The rate of C-section was 43.4% (26.5%: emergency, 16.9%: elective). Percentage of infant overweight was 14.9%. Compared to vaginal delivery, elective C-section was associated with <jats:italic>\u03b2<\/jats:italic>\u2009=\u20090.57 (95% CI 0.20, 0.95) higher BMI <jats:italic>z<\/jats:italic>. Also infants born by elective C-section had RR\u2009=\u20092.44 (95% CI 1.35, 4.41) higher risk of being overweight; no such association was found for emergency C-section. Also, elective C-section delivery was associated with reduced linear growth at 1 year after multiple imputation (<jats:italic>\u03b2<\/jats:italic>\u2009=\u2009\u22120.38, 95% CI \u22120.76, \u22120.01).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Elective\u00a0C-section delivery\u00a0might contribute to excess weight and also possibly\u00a0reduced linear growth at 1 year of age\u00a0in children from low- and middle-income countries.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Impact<\/jats:title>\n                <jats:p><jats:list list-type=\"bullet\">\n                  <jats:list-item>\n                    <jats:p>Our study, in a low-income setting, suggests that elective, but not emergency, C-section is associated with excess infant BMI <jats:italic>z<\/jats:italic> at 1 year of age and elective C (C-section) was also associated with altered linear growth but only in multiple imputation analyses.<\/jats:p>\n                  <\/jats:list-item>\n                  <jats:list-item>\n                    <jats:p>Elective C-section was associated with a higher risk of being overweight at 1 year of age.<\/jats:p>\n                  <\/jats:list-item>\n                  <jats:list-item>\n                    <jats:p>Our results indicate that decreasing medically unnecessary elective C-section deliveries may help limit excess weight gain and stunted linear growth among infants.<\/jats:p>\n                  <\/jats:list-item>\n                <\/jats:list><\/jats:p>\n              <\/jats:sec>","DOI":"10.1038\/s41390-021-01417-6","type":"journal-article","created":{"date-parts":[[2021,3,2]],"date-time":"2021-03-02T13:03:10Z","timestamp":1614690190000},"page":"1251-1257","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Delivery mode and altered infant growth at 1 year of life in India"],"prefix":"10.1038","volume":"90","author":[{"given":"Giridhara R.","family":"Babu","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Noel T.","family":"Mueller","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Melissa Glenda","family":"Lewis","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anjaly","family":"Krishnan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eunice","family":"Lobo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R.","family":"Deepa","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sonalini","family":"Khetrapal","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sara E.","family":"Benjamin-Neelon","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2021,3,2]]},"reference":[{"key":"1417_CR1","doi-asserted-by":"publisher","first-page":"65","DOI":"10.1016\/S0140-6736(19)32497-3","volume":"395","author":"BM Popkin","year":"2020","unstructured":"Popkin, B. 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