{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T04:25:11Z","timestamp":1790310311277,"version":"4.1.0"},"reference-count":41,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[2019,5,21]],"date-time":"2019-05-21T00:00:00Z","timestamp":1558396800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"name":"S\u00e3o Paulo State Research Foundation"},{"name":"Brazilian National Research Council"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,7,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>The rate of cesarean delivery (CD) is high in many parts of the world. Birth via CD has been associated with adverse later health outcomes, such as obesity, asthma, and type 1 diabetes mellitus. Few studies have focused on hypertension. We investigated the associations of CD with hypertension, systolic blood pressure (BP), and diastolic BP and tested whether body mass index (BMI; weight (kg)\/height (m)2) was a mediator of these associations in a birth cohort (n = 2,020) assembled in 1978\u20131979 and followed up in 2002\u20132004 in Ribeir\u00e3o Preto, Brazil. The CD rate was 32.0%. Hypertension was present in 11.7% of persons born via CD and 7.7% of those born vaginally. Being born by CD increased the odds of hypertension by 51% (odds ratio = 1.51, 95% confidence interval (CI): 1.10, 2.07). After adjustment for confounders, this estimate changed little (odds ratio = 1.49, 95% CI: 1.07, 2.06). In a mediation analysis, odds ratios for the indirect and direct effects were 1.18 (95% CI: 1.11, 1.25) and 1.31 (95% CI: 0.97, 1.65), respectively. CD also had indirect effects on both systolic and diastolic BP via BMI. Our findings suggest that CD is associated with young-adult hypertension and that this association is at least partially mediated by BMI. This has implications for countries struggling with the burden of noncommunicable diseases and where CD rates are high.<\/jats:p>","DOI":"10.1093\/aje\/kwz096","type":"journal-article","created":{"date-parts":[[2019,4,5]],"date-time":"2019-04-05T15:23:49Z","timestamp":1554477829000},"page":"1296-1303","source":"Crossref","is-referenced-by-count":17,"title":["Cesarean Delivery and Hypertension in Early Adulthood"],"prefix":"10.1093","volume":"188","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1439-8091","authenticated-orcid":false,"given":"Alexandre Archanjo","family":"Ferraro","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Faculty of Medicine, University of S\u00e3o Paulo, S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco Ant\u00f4nio","family":"Barbieri","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Faculty of Medicine of Ribeir\u00e3o Preto, University of S\u00e3o Paulo, Ribeir\u00e3o Preto, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio Augusto Moura","family":"da Silva","sequence":"additional","affiliation":[{"name":"Department of Public Health, University of Maranh\u00e3o, S\u00e3o Luis, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcelo Zubaran","family":"Goldani","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Faculty of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Teresa Bechere","family":"Fernandes","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Faculty of Medicine, University of S\u00e3o Paulo, S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Viviane Cunha","family":"Cardoso","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Faculty of Medicine of Ribeir\u00e3o Preto, University of S\u00e3o Paulo, Ribeir\u00e3o Preto, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1138-6458","authenticated-orcid":false,"given":"Aryeh David","family":"Stein","sequence":"additional","affiliation":[{"name":"Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heloisa","family":"Bettiol","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Faculty of Medicine of Ribeir\u00e3o Preto, University of S\u00e3o Paulo, Ribeir\u00e3o Preto, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2019,5,21]]},"reference":[{"issue":"9780","key":"2019070110030669800_kwz096C1","doi-asserted-by":"crossref","first-page":"1863","DOI":"10.1016\/S0140-6736(11)60138-4","article-title":"Maternal and child health in Brazil: progress and challenges","volume":"377","author":"Victora","year":"2011","journal-title":"Lancet"},{"key":"2019070110030669800_kwz096C2","doi-asserted-by":"crossref","first-page":"Article 57","DOI":"10.1186\/s12978-015-0043-6","article-title":"What is the optimal rate of caesarean section at population level? 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