{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,8]],"date-time":"2026-02-08T14:15:58Z","timestamp":1770560158765,"version":"3.49.0"},"reference-count":20,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2021,11,26]],"date-time":"2021-11-26T00:00:00Z","timestamp":1637884800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100000329","name":"Novo Nordisk UK Research Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000329","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81872630"],"award-info":[{"award-number":["81872630"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100012049","name":"Healthy Communities Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100012049","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Paediatric Perinatal Epid"],"published-print":{"date-parts":[[2022,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>There is considerable public and scientific interest in the declining age of pubertal timing. Prenatal and postnatal stress has been proposed to relate with earlier pubertal timing, but it remains unknown whether intrapartum stress may affect pubertal timing as well.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>This study aims to examine the potential effect of caesarean delivery on pubertal timing in boys and girls.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This study was based upon the nationwide Puberty Cohort nested within the Danish National Birth Cohort (DNBC) from 2000 to 2003. A total of 15,731\u00a0mother\u2010child pairs with complete information on delivery mode and puberty were included in the main analysis. The delivery mode was categorised into non\u2010instrumental vaginal delivery (reference), instrumental vaginal delivery, elective caesarean delivery before labour, emergency caesarean delivery during labour and un\u2010specified caesarean delivery. Children's pubertal development were self\u2010reported in web\u2010based questionnaires from 11\u00a0years of age and every 6\u00a0months throughout puberty (2012\u20132019), including Tanner stages 2\u20135, menarche, voice break, first ejaculation, axillary hair growth and the onset of acne. Regression models for censored, normally distributed time\u2010to\u2010event data were used to estimate mean monthly differences in age at attaining the different pubertal milestones and the average of all these estimates for each sex (a combined indicator of pubertal timing).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 2810 participants were born by caesarean delivery (17.9%). Neither elective nor emergency caesarean delivery was associated with earlier age at achieving the pubertal milestones in boys or in girls. For the combined indicator, the mean age differences for elective caesarean delivery and emergency caesarean delivery were 0.1 (95% CI \u22121.1, 1.4) months and \u22120.7 (95% CI \u22122.0, 0.5) months in boys and 0.7 (95% CI \u22120.7, 2.0) and 0.2 (95% CI \u22121.3, 1.7) in girls.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This study does not suggest a clinically important effect of caesarean delivery on children's pubertal timing.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ppe.12827","type":"journal-article","created":{"date-parts":[[2021,11,26]],"date-time":"2021-11-26T12:08:16Z","timestamp":1637928496000},"page":"104-112","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Caesarean delivery and pubertal timing in boys and girls: A Danish population\u2010based cohort study"],"prefix":"10.1111","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1702-9956","authenticated-orcid":false,"given":"Kun","family":"Huang","sequence":"first","affiliation":[{"name":"Department of Maternal, Child and Adolescent Health, Scientific Research Center in Preventive Medicine MOE Key Laboratory of Population Health Across Life Cycle NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract Anhui Provincial Key Laboratory of Population Health and Aristogenics School of Public Health Anhui Medical University  Hefei China"},{"name":"Research Unit for Epidemiology, Department of Public Health Aarhus University  Aarhus C Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anne","family":"Gaml\u2010S\u00f8rensen","sequence":"additional","affiliation":[{"name":"Research Unit for Epidemiology, Department of Public Health Aarhus University  Aarhus C Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lea Lykke Harrits","family":"Lunddorf","sequence":"additional","affiliation":[{"name":"Research Unit for Epidemiology, Department of Public Health Aarhus University  Aarhus C Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5533-8891","authenticated-orcid":false,"given":"Andreas","family":"Ernst","sequence":"additional","affiliation":[{"name":"Research Unit for Epidemiology, Department of Public Health Aarhus University  Aarhus C Denmark"},{"name":"Department of Urology Aarhus University Hospital  Aarhus N Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nis","family":"Brix","sequence":"additional","affiliation":[{"name":"Research Unit for Epidemiology, Department of Public Health Aarhus University  Aarhus C Denmark"},{"name":"Department of Clinical Genetics Aarhus University Hospital  Aarhus N 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