{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T06:18:09Z","timestamp":1784182689095,"version":"3.55.0"},"reference-count":57,"publisher":"Springer Science and Business Media LLC","issue":"3","license":[{"start":{"date-parts":[[2021,4,6]],"date-time":"2021-04-06T00:00:00Z","timestamp":1617667200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,4,6]],"date-time":"2021-04-06T00:00:00Z","timestamp":1617667200000},"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":[[2022,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>We assessed differences in plasma levels of metabolic health and inflammation biomarkers during mid-childhood and early adolescence between children born by cesarean section vs. vaginal delivery.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>Mother\u2013child pairs (<jats:italic>N<\/jats:italic>\u2009=\u2009942) enrolled during pregnancy in obstetric practices and child follow-up started at birth. Risk biomarkers were assessed in blood samples collected at the mild-childhood (median\u2009=\u20097 years) and early adolescence (median\u2009=\u200913 years) in-person visits.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Two hundred and six children (22%) were born by cesarean section. There were no significant differences in biomarker levels between children born by cesarean and children born vaginally in mid-childhood. However, adolescents born by cesarean section had significantly lower adiponectin [% difference (95% confidence interval (CI))\u2009=\u2009\u221211.3 (\u221218.1, \u22124.0)\u2009\u00b5g\/mL] compared to vaginal delivery. We also found some suggestion of higher insulin resistance [insulin levels % difference (95% CI)\u2009=\u200911.5 (\u22120.40, 25.0)\u2009\u00b5U\/mL and HOMA-IR (homeostatic model assessment of insulin resistance) % difference (95% CI)\u2009=\u20099.1 (\u22122.30, 21.8)\u2009U] in adolescents born by cesarean section compared to those born vaginally.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>We found suggestive evidence that adolescents born by cesarean section show differences in certain metabolic health biomarkers relative to adolescents born by vaginal delivery. Further studies are needed to reevaluate these associations since the clinical significance of these differences is unclear.<\/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>Multiple studies show that children born by cesarean section are at higher risk of obesity compared to those born vaginally.<\/jats:p>\n                  <\/jats:list-item>\n                  <jats:list-item>\n                    <jats:p>It is unclear yet to what extent this elevated risk may extend to a more adverse profile of biomarkers of metabolic health and inflammation.<\/jats:p>\n                  <\/jats:list-item>\n                  <jats:list-item>\n                    <jats:p>Adolescents born by cesarean section show small differences in adiponectin and insulin relative to adolescents born by vaginal delivery.<\/jats:p>\n                  <\/jats:list-item>\n                  <jats:list-item>\n                    <jats:p>Adolescents born by cesarean section may be at higher risk to a more adverse profile of biomarkers of metabolic health and inflammation, but the clinical significance of these differences is uncertain.<\/jats:p>\n                  <\/jats:list-item>\n                <\/jats:list><\/jats:p>\n              <\/jats:sec>","DOI":"10.1038\/s41390-021-01503-9","type":"journal-article","created":{"date-parts":[[2021,4,6]],"date-time":"2021-04-06T21:03:13Z","timestamp":1617742993000},"page":"672-680","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Cesarean delivery and metabolic health and inflammation biomarkers during mid-childhood and early adolescence"],"prefix":"10.1038","volume":"91","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2370-3900","authenticated-orcid":false,"given":"Lidia","family":"M\u00ednguez-Alarc\u00f3n","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sheryl L.","family":"Rifas-Shiman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caroline","family":"Mitchell","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joanne","family":"Sordillo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Izzuddin M.","family":"Aris","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie-France","family":"Hivert","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily","family":"Oken","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jorge E.","family":"Chavarro","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,4,6]]},"reference":[{"key":"1503_CR1","unstructured":"HCUP Fast Stats. Healthcare Cost and Utilization Project (HCUP) (Agency for Healthcare Research and Quality, 2019)."},{"key":"1503_CR2","unstructured":"Martin, J. A., Hamilton, B. E. & Osterman, M. J. K. Births in the United States, 2018. NCHS Data Brief 346, 1\u20138 (2019)."},{"key":"1503_CR3","unstructured":"Martin, J. A., Hamilton, B. E. & Osterman, M. J. K. Births in the United States, 2017. NCHS Data Brief 318, 1\u20138 (2018)."},{"key":"1503_CR4","doi-asserted-by":"publisher","first-page":"7","DOI":"10.1055\/s-0031-1285829","volume":"29","author":"KD Gregory","year":"2012","unstructured":"Gregory, K. D., Jackson, S., Korst, L. & Fridman, M. Cesarean versus vaginal delivery: whose risks? Whose benefits? Am. J. Perinatol. 29, 7\u201318 (2012).","journal-title":"Am. J. Perinatol."},{"key":"1503_CR5","doi-asserted-by":"publisher","first-page":"455","DOI":"10.1503\/cmaj.060870","volume":"176","author":"S Liu","year":"2007","unstructured":"Liu, S. et al. Maternal mortality and severe morbidity associated with low-risk planned cesarean delivery versus planned vaginal delivery at term. CMAJ 176, 455\u2013460 (2007).","journal-title":"CMAJ"},{"key":"1503_CR6","doi-asserted-by":"publisher","first-page":"85","DOI":"10.1136\/bmj.39405.539282.BE","volume":"336","author":"AK Hansen","year":"2008","unstructured":"Hansen, A. K., Wisborg, K., Uldbjerg, N. & Henriksen, T. B. Risk of respiratory morbidity in term infants delivered by elective caesarean section: cohort study. BMJ 336, 85\u201387 (2008).","journal-title":"BMJ"},{"key":"1503_CR7","doi-asserted-by":"publisher","first-page":"243","DOI":"10.1080\/14767050410001668653","volume":"15","author":"G Loebel","year":"2004","unstructured":"Loebel, G., Zelop, C. M., Egan, J. F. & Wax, J. Maternal and neonatal morbidity after elective repeat Cesarean delivery versus a trial of labor after previous Cesarean delivery in a community teaching hospital. J. Matern. Fetal Neonatal Med. 15, 243\u2013246 (2004).","journal-title":"J. Matern. Fetal Neonatal Med."},{"key":"1503_CR8","doi-asserted-by":"publisher","first-page":"h2410","DOI":"10.1136\/bmj.h2410","volume":"350","author":"J Blustein","year":"2015","unstructured":"Blustein, J. & Liu, J. Time to consider the risks of caesarean delivery for long term child health. BMJ 350, h2410 (2015).","journal-title":"BMJ"},{"key":"1503_CR9","doi-asserted-by":"publisher","first-page":"726","DOI":"10.1007\/s00125-008-0941-z","volume":"51","author":"CR Cardwell","year":"2008","unstructured":"Cardwell, C. R. et al. Caesarean section is associated with an increased risk of childhood-onset type 1 diabetes mellitus: a meta-analysis of observational studies. Diabetologia 51, 726\u2013735 (2008).","journal-title":"Diabetologia"},{"key":"1503_CR10","doi-asserted-by":"publisher","first-page":"842","DOI":"10.1111\/cea.12253","volume":"44","author":"TR Abrahamsson","year":"2014","unstructured":"Abrahamsson, T. R. et al. Low gut microbiota diversity in early infancy precedes asthma at school age. Clin. Exp. Allergy 44, 842\u2013850 (2014).","journal-title":"Clin. Exp. Allergy"},{"key":"1503_CR11","doi-asserted-by":"publisher","first-page":"400","DOI":"10.1097\/ACI.0b013e328349b166","volume":"11","author":"AL Kozyrskyj","year":"2011","unstructured":"Kozyrskyj, A. L., Bahreinian, S. & Azad, M. B. Early life exposures: impact on asthma and allergic disease. Curr. Opin. Allergy Clin. Immunol. 11, 400\u2013406 (2011).","journal-title":"Curr. Opin. Allergy Clin. Immunol."},{"key":"1503_CR12","doi-asserted-by":"publisher","first-page":"629","DOI":"10.1111\/j.1365-2222.2007.02780.x","volume":"38","author":"S Thavagnanam","year":"2008","unstructured":"Thavagnanam, S. et al. A meta-analysis of the association between caesarean section and childhood asthma. Clin. Exp. Allergy 38, 629\u2013633 (2008).","journal-title":"Clin. Exp. Allergy"},{"key":"1503_CR13","doi-asserted-by":"publisher","first-page":"1473","DOI":"10.1177\/1352458513480010","volume":"19","author":"NM Nielsen","year":"2013","unstructured":"Nielsen, N. M. et al. Cesarean section and offspring\u2019s risk of multiple sclerosis: a Danish nationwide cohort study. Mult. Scler. 19, 1473\u20131477 (2013).","journal-title":"Mult. Scler."},{"key":"1503_CR14","doi-asserted-by":"publisher","first-page":"e92","DOI":"10.1542\/peds.2014-0596","volume":"135","author":"A Sevelsted","year":"2015","unstructured":"Sevelsted, A., Stokholm, J., Bonnelykke, K. & Bisgaard, H. Cesarean section and chronic immune disorders. Pediatrics 135, e92\u2013e98 (2015).","journal-title":"Pediatrics"},{"key":"1503_CR15","doi-asserted-by":"publisher","first-page":"249","DOI":"10.1016\/j.ajog.2012.08.009","volume":"208","author":"CE Cho","year":"2013","unstructured":"Cho, C. E. & Norman, M. Cesarean section and development of the immune system in the offspring. Am. J. Obstet. Gynecol. 208, 249\u2013254 (2013).","journal-title":"Am. J. Obstet. Gynecol."},{"key":"1503_CR16","doi-asserted-by":"publisher","first-page":"254","DOI":"10.1089\/chi.2018.0335","volume":"15","author":"SS Hawkins","year":"2019","unstructured":"Hawkins, S. S. et al. Examining associations between perinatal and postnatal risk factors for childhood obesity using sibling comparisons. Child. Obes. 15, 254\u2013261 (2019).","journal-title":"Child. Obes."},{"key":"1503_CR17","doi-asserted-by":"publisher","first-page":"777","DOI":"10.1001\/jamapediatrics.2018.0674","volume":"172","author":"SL Rifas-Shiman","year":"2018","unstructured":"Rifas-Shiman, S. L. et al. Association of cesarean delivery with body mass index z score at age 5 years. JAMA Pediatr. 172, 777\u2013779 (2018).","journal-title":"JAMA Pediatr."},{"key":"1503_CR18","doi-asserted-by":"publisher","first-page":"e162385","DOI":"10.1001\/jamapediatrics.2016.2385","volume":"170","author":"C Yuan","year":"2016","unstructured":"Yuan, C. et al. Association between cesarean birth and risk of obesity in offspring in childhood, adolescence, and early adulthood. JAMA Pediatr. 170, e162385 (2016).","journal-title":"JAMA Pediatr."},{"key":"1503_CR19","doi-asserted-by":"publisher","first-page":"526","DOI":"10.1136\/archdischild-2012-303459","volume":"98","author":"K Flemming","year":"2013","unstructured":"Flemming, K. et al. The association between caesarean section and childhood obesity revisited: a cohort study. Arch. Dis. Child. 98, 526\u2013532 (2013).","journal-title":"Arch. Dis. Child."},{"key":"1503_CR20","doi-asserted-by":"publisher","first-page":"1068","DOI":"10.1016\/j.jpeds.2013.12.044","volume":"164","author":"Z Pei","year":"2014","unstructured":"Pei, Z. et al. Cesarean delivery and risk of childhood obesity. J. Pediatr. 164, 1068\u20131073.e2 (2014).","journal-title":"J. Pediatr."},{"key":"1503_CR21","doi-asserted-by":"publisher","first-page":"610","DOI":"10.1136\/archdischild-2011-301141","volume":"97","author":"SY Huh","year":"2012","unstructured":"Huh, S. Y. et al. Delivery by caesarean section and risk of obesity in preschool age children: a prospective cohort study. Arch. Dis. Child. 97, 610\u2013616 (2012).","journal-title":"Arch. Dis. Child."},{"key":"1503_CR22","doi-asserted-by":"publisher","first-page":"893","DOI":"10.1038\/ijo.2012.195","volume":"37","author":"HT Li","year":"2013","unstructured":"Li, H. T., Zhou, Y. B. & Liu, J. M. The impact of cesarean section on offspring overweight and obesity: a systematic review and meta-analysis. Int. J. Obes. 37, 893\u2013899 (2013).","journal-title":"Int. J. Obes."},{"key":"1503_CR23","doi-asserted-by":"publisher","first-page":"e87896","DOI":"10.1371\/journal.pone.0087896","volume":"9","author":"K Darmasseelane","year":"2014","unstructured":"Darmasseelane, K. et al. Mode of delivery and offspring body mass index, overweight and obesity in adult life: a systematic review and meta-analysis. PLoS ONE 9, e87896 (2014).","journal-title":"PLoS ONE"},{"key":"1503_CR24","doi-asserted-by":"publisher","first-page":"295","DOI":"10.1111\/obr.12267","volume":"16","author":"S Kuhle","year":"2015","unstructured":"Kuhle, S., Tong, O. S. & Woolcott, C. G. Association between caesarean section and childhood obesity: a systematic review and meta-analysis. Obes. Rev. 16, 295\u2013303 (2015).","journal-title":"Obes. Rev."},{"key":"1503_CR25","doi-asserted-by":"crossref","unstructured":"Mueller, N. T., Zhang, M., Rifas-Shiman, S. L., Oken, E., Hivert, M. F. & Chavarro, J. Mode of delivery, type of labor, and measures of adiposity from childhood to teenage: Project Viva. Int. J. Obes. (Lond) 45, 36\u201344 (2021).","DOI":"10.1038\/s41366-020-00709-x"},{"key":"1503_CR26","doi-asserted-by":"publisher","first-page":"e202605","DOI":"10.1001\/jamanetworkopen.2020.2605","volume":"3","author":"JE Chavarro","year":"2020","unstructured":"Chavarro, J. E. et al. Association of birth by cesarean delivery with obesity and type 2 diabetes among adult women. JAMA Netw. Open 3, e202605 (2020).","journal-title":"JAMA Netw. Open"},{"key":"1503_CR27","doi-asserted-by":"publisher","first-page":"e74301","DOI":"10.1371\/journal.pone.0074301","volume":"8","author":"BL Horta","year":"2013","unstructured":"Horta, B. L. et al. Birth by caesarean section and prevalence of risk factors for non-communicable diseases in young adults: a birth cohort study. PLoS ONE 8, e74301 (2013).","journal-title":"PLoS ONE"},{"key":"1503_CR28","doi-asserted-by":"publisher","first-page":"295","DOI":"10.3945\/ajcn.114.105205","volume":"102","author":"JR Bernardi","year":"2015","unstructured":"Bernardi, J. R. et al. Cesarean delivery and metabolic risk factors in young adults: a Brazilian birth cohort study. Am. J. Clin. Nutr. 102, 295\u2013301 (2015).","journal-title":"Am. J. Clin. Nutr."},{"key":"1503_CR29","doi-asserted-by":"publisher","first-page":"15","DOI":"10.1038\/ijo.2017.175","volume":"42","author":"S Hansen","year":"2018","unstructured":"Hansen, S. et al. Birth by cesarean section in relation to adult offspring overweight and biomarkers of cardiometabolic risk. Int. J. Obes. 42, 15\u201319 (2018).","journal-title":"Int. J. Obes."},{"key":"1503_CR30","doi-asserted-by":"publisher","first-page":"240","DOI":"10.1016\/j.jpeds.2003.10.064","volume":"144","author":"MW Gillman","year":"2004","unstructured":"Gillman, M. W. et al. Maternal age and other predictors of newborn blood pressure. J. Pediatr. 144, 240\u2013245 (2004).","journal-title":"J. Pediatr."},{"key":"1503_CR31","doi-asserted-by":"publisher","first-page":"e500","DOI":"10.1542\/peds.2004-1921","volume":"115","author":"M Keskin","year":"2005","unstructured":"Keskin, M. et al. Homeostasis model assessment is more reliable than the fasting glucose\/insulin ratio and quantitative insulin sensitivity check index for assessing insulin resistance among obese children and adolescents. Pediatrics 115, e500\u2013e503 (2005).","journal-title":"Pediatrics"},{"key":"1503_CR32","first-page":"1","volume":"39","author":"CD Fryar","year":"2016","unstructured":"Fryar, C. D., Gu, Q., Ogden, C. L. & Flegal, K. M. Anthropometric reference data for children and adults: United States, 2011-2014. Vital Health Stat. Ser. 3 39, 1\u201346 (2016).","journal-title":"Vital Health Stat. Ser. 3"},{"key":"1503_CR33","doi-asserted-by":"publisher","first-page":"e20171904","DOI":"10.1542\/peds.2017-1904","volume":"140","author":"JT Flynn","year":"2017","unstructured":"Flynn, J. T. et al. Clinical practice guideline for screening and management of high blood pressure in children and adolescents. Pediatrics 140, e20171904 (2017) .","journal-title":"Pediatrics"},{"key":"1503_CR34","doi-asserted-by":"publisher","first-page":"2427","DOI":"10.2337\/dc06-0709","volume":"29","author":"JM Lee","year":"2006","unstructured":"Lee, J. M. et al. Prevalence and determinants of insulin resistance among U.S. adolescents: a population-based study. Diabetes Care 29, 2427\u20132432 (2006).","journal-title":"Diabetes Care"},{"key":"1503_CR35","doi-asserted-by":"publisher","first-page":"6","DOI":"10.1186\/1471-2431-3-6","volume":"3","author":"E Oken","year":"2003","unstructured":"Oken, E., Kleinman, K. P., Rich-Edwards, J. & Gillman, M. W. A nearly continuous measure of birth weight for gestational age using a United States national reference. BMC Pediatr. 3, 6 (2003).","journal-title":"BMC Pediatr."},{"key":"1503_CR36","doi-asserted-by":"publisher","first-page":"117","DOI":"10.1007\/BF01537962","volume":"17","author":"AC Petersen","year":"1988","unstructured":"Petersen, A. C., Crockett, L., Richards, M. & Boxer, A. A self-report measure of pubertal status: Reliability, validity, and initial norms. J. Youth Adolesc. 17, 117\u2013133 (1988).","journal-title":"J. Youth Adolesc."},{"key":"1503_CR37","doi-asserted-by":"publisher","first-page":"615","DOI":"10.1097\/01.ede.0000135174.63482.43","volume":"15","author":"MA Hern\u00e1n","year":"2004","unstructured":"Hern\u00e1n, M. A., Hern\u00e1ndez-D\u00edaz, S. & Robins, J. M. A structural approach to selection bias. Epidemiology15, 615\u2013625 (2004).","journal-title":"Epidemiology"},{"key":"1503_CR38","unstructured":"Rothman, K. & Greenland, S. Modern Epidemiology 2nd edn (Lippincott-Raven, 1998)."},{"key":"1503_CR39","doi-asserted-by":"publisher","first-page":"743","DOI":"10.1016\/j.jpeds.2011.10.037","volume":"160","author":"A Must","year":"2012","unstructured":"Must, A., Phillips, S. M. & Naumova, E. N. Occurrence and timing of childhood overweight and mortality: findings from the Third Harvard Growth Study. J. Pediatr. 160, 743\u2013750 (2012).","journal-title":"J. Pediatr."},{"key":"1503_CR40","doi-asserted-by":"publisher","first-page":"56","DOI":"10.1111\/obr.12316","volume":"17","author":"A Llewellyn","year":"2016","unstructured":"Llewellyn, A., Simmonds, M., Owen, C. G. & Woolacott, N. Childhood obesity as a predictor of morbidity in adulthood: a systematic review and meta-analysis. Obes. Rev. 17, 56\u201367 (2016).","journal-title":"Obes. Rev."},{"key":"1503_CR41","doi-asserted-by":"publisher","first-page":"30","DOI":"10.1093\/aje\/kwn096","volume":"168","author":"T Bjorge","year":"2008","unstructured":"Bjorge, T., Engeland, A., Tverdal, A. & Smith, G. D. Body mass index in adolescence in relation to cause-specific mortality: a follow-up of 230,000 Norwegian adolescents. Am. J. Epidemiol. 168, 30\u201337 (2008).","journal-title":"Am. J. Epidemiol."},{"key":"1503_CR42","doi-asserted-by":"publisher","first-page":"2430","DOI":"10.1056\/NEJMoa1503840","volume":"374","author":"G Twig","year":"2016","unstructured":"Twig, G. et al. Body-mass index in 2.3 million adolescents and cardiovascular death in adulthood. N. Engl. J. Med. 374, 2430\u20132440 (2016).","journal-title":"N. Engl. J. Med."},{"key":"1503_CR43","doi-asserted-by":"publisher","first-page":"19","DOI":"10.1097\/00005176-199901000-00007","volume":"28","author":"MM Gronlund","year":"1999","unstructured":"Gronlund, M. M., Lehtonen, O. P., Eerola, E. & Kero, P. Fecal microflora in healthy infants born by different methods of delivery: permanent changes in intestinal flora after cesarean delivery. J. Pediatr. Gastroenterol. Nutr. 28, 19\u201325 (1999).","journal-title":"J. Pediatr. Gastroenterol. Nutr."},{"key":"1503_CR44","doi-asserted-by":"publisher","first-page":"511","DOI":"10.1542\/peds.2005-2824","volume":"118","author":"J Penders","year":"2006","unstructured":"Penders, J. et al. Factors influencing the composition of the intestinal microbiota in early infancy. Pediatrics 118, 511\u2013521 (2006).","journal-title":"Pediatrics"},{"key":"1503_CR45","doi-asserted-by":"publisher","first-page":"86","DOI":"10.1186\/s12876-016-0498-0","volume":"16","author":"E Rutayisire","year":"2016","unstructured":"Rutayisire, E., Huang, K., Liu, Y. & Tao, F. The mode of delivery affects the diversity and colonization pattern of the gut microbiota during the first year of infants\u2019 life: a systematic review. BMC Gastroenterol. 16, 86 (2016).","journal-title":"BMC Gastroenterol."},{"key":"1503_CR46","doi-asserted-by":"publisher","first-page":"117","DOI":"10.1038\/s41586-019-1560-1","volume":"574","author":"Y Shao","year":"2019","unstructured":"Shao, Y. et al. Stunted microbiota and opportunistic pathogen colonization in caesarean-section birth. Nature 574, 117\u2013121 (2019).","journal-title":"Nature"},{"key":"1503_CR47","doi-asserted-by":"publisher","DOI":"10.1186\/s40168-016-0213-y","volume":"5","author":"CJ Hill","year":"2017","unstructured":"Hill, C. J. et al. Evolution of gut microbiota composition from birth to 24 weeks in the INFANTMET Cohort. Microbiome 5, 4 (2017).","journal-title":"Microbiome"},{"key":"1503_CR48","doi-asserted-by":"publisher","first-page":"343ra82","DOI":"10.1126\/scitranslmed.aad7121","volume":"8","author":"NA Bokulich","year":"2016","unstructured":"Bokulich, N. A. et al. Antibiotics, birth mode, and diet shape microbiome maturation during early life. Sci. Transl. Med. 8, 343ra82 (2016).","journal-title":"Sci. Transl. Med."},{"key":"1503_CR49","doi-asserted-by":"publisher","first-page":"212","DOI":"10.1001\/jamapediatrics.2015.3732","volume":"170","author":"JC Madan","year":"2016","unstructured":"Madan, J. C. et al. Association of cesarean delivery and formula supplementation with the intestinal microbiome of 6-week-old infants. JAMA Pediatr. 170, 212\u2013219 (2016).","journal-title":"JAMA Pediatr."},{"key":"1503_CR50","doi-asserted-by":"publisher","first-page":"5","DOI":"10.1097\/MOG.0b013e328333d751","volume":"26","author":"RE Ley","year":"2010","unstructured":"Ley, R. E. Obesity and the human microbiome. Curr. Opin. Gastroenterol. 26, 5\u201311 (2010).","journal-title":"Curr. Opin. Gastroenterol."},{"key":"1503_CR51","doi-asserted-by":"publisher","first-page":"1022","DOI":"10.1038\/4441022a","volume":"444","author":"RE Ley","year":"2006","unstructured":"Ley, R. E., Turnbaugh, P. J., Klein, S. & Gordon, J. I. Microbial ecology: human gut microbes associated with obesity. Nature 444, 1022\u20131023 (2006).","journal-title":"Nature"},{"key":"1503_CR52","doi-asserted-by":"publisher","first-page":"758","DOI":"10.1038\/ijo.2008.260","volume":"33","author":"I Nadal","year":"2009","unstructured":"Nadal, I. et al. Shifts in clostridia, bacteroides and immunoglobulin-coating fecal bacteria associated with weight loss in obese adolescents. Int. J. Obes. 33, 758\u2013767 (2009).","journal-title":"Int. J. Obes."},{"key":"1503_CR53","doi-asserted-by":"publisher","first-page":"39","DOI":"10.1016\/j.mam.2012.11.001","volume":"34","author":"J Shen","year":"2013","unstructured":"Shen, J., Obin, M. S. & Zhao, L. The gut microbiota, obesity and insulin resistance. Mol. Asp. Med. 34, 39\u201358 (2013).","journal-title":"Mol. Asp. Med."},{"key":"1503_CR54","doi-asserted-by":"publisher","first-page":"64","DOI":"10.1007\/s11892-016-0751-5","volume":"16","author":"MM Kelsey","year":"2016","unstructured":"Kelsey, M. M. & Zeitler, P. S. Insulin resistance of puberty. Curr. Diab. Rep. 16, 64 (2016).","journal-title":"Curr. Diab. Rep."},{"key":"1503_CR55","doi-asserted-by":"publisher","first-page":"829","DOI":"10.2307\/1130220","volume":"58","author":"J Brooks-Gunn","year":"1987","unstructured":"Brooks-Gunn, J., Warren, M. P., Rosso, J. & Gargiulo, J. Validity of self-report measures of girls\u2019 pubertal status. Child Dev. 58, 829\u2013841 (1987).","journal-title":"Child Dev."},{"key":"1503_CR56","doi-asserted-by":"publisher","first-page":"357","DOI":"10.1177\/0272431604268531","volume":"24","author":"KE Schmitz","year":"2004","unstructured":"Schmitz, K. E. et al. A validation study of early adolescents\u2019 pubertal self-assessments. J. Early Adolesc. 24, 357\u2013384 (2004).","journal-title":"J. Early Adolesc."},{"key":"1503_CR57","doi-asserted-by":"publisher","first-page":"1661","DOI":"10.1002\/oby.22592","volume":"27","author":"IM Aris","year":"2019","unstructured":"Aris, I. M. et al. Association of BMI with linear growth and pubertal development. Obesity 27, 1661\u20131670 (2019).","journal-title":"Obesity"}],"container-title":["Pediatric Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41390-021-01503-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41390-021-01503-9","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41390-021-01503-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,1,31]],"date-time":"2023-01-31T05:33:07Z","timestamp":1675143187000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41390-021-01503-9"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,4,6]]},"references-count":57,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2022,2]]}},"alternative-id":["1503"],"URL":"https:\/\/doi.org\/10.1038\/s41390-021-01503-9","relation":{},"ISSN":["0031-3998","1530-0447"],"issn-type":[{"value":"0031-3998","type":"print"},{"value":"1530-0447","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,4,6]]},"assertion":[{"value":"23 November 2020","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"10 March 2021","order":2,"name":"revised","label":"Revised","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"15 March 2021","order":3,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"6 April 2021","order":4,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The authors declare no competing interests.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}},{"value":"Written informed consent was obtained from each participant.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Patient consent"}}]}}