Nascimento por cesariana e adiposidade central em adolescentes de uma coorte de nascimentos (RPS) de uma capital do nordeste brasileiro
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2018-02-26
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Universidade Federal do Maranhão
Resumo
INTRODUCTION: Caesarean section has been associated with the development of obesity
and metabolic changes throughout life, but studies on the association with central fat, more
associated with cardiovascular risk, are not consensual. OBJECTIVE: To evaluate the causal
effect between cesarean birth and central adiposity of the body in adolescents. METHODS:
A cohort study was carried out, including 601 participants, evaluated at birth and in
adolescence aged 17 to 18 years. The following ratios were evaluated by DEXA as the
definition of central fat: android / gynoid fat mass (A/G); trunk / total fat mass (T/T); fat mass
of the trunk / limbs (T/LB) and fat mass of the trunk / legs (T/LG). A Directed Acyclic Graph
(DAG) was constructed to select the variables for minimum adjustment for confounding,
being selected: intrauterine growth retardation, gestational age at birth, maternal schooling,
maternal smoking, mother's BMI, family income at birth and the mother's marital status. In
the analysis, a marginal structural model was used, which allows a better adjustment of the
confounders. We also used inverse-weighted estimators of the likelihood of exposure
selection. The presence of interchangeability between the exposure groups was verified by the
teballance command of the software StataTM v. 14. RESULTS: There was no statistical
difference in the central fat mass of adolescents born by cesarean section or vaginal route, for
the four indicators used: A/G ratios (CI 95% = -0.015, 0.018, P = 0.875); T/T ratio (CI 95% =
-0.013; 0.007, P = 0.541); T/LB ratio (CI 95% = -0.048; 0.016; P = .333); T/LG ratio (CI 95%
= -0.06; 0.03, P = 0.532). CONCLUSION: In the present study, no causal effect was
observed between cesarean births and the higher presence of central fat in the adolescents
studied.
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Palavras-chave
Cesariana, Adiposidade, Adolescente, Caesarean section, Adiposity, Adolescent
Citação
ABREU, Joana D’Arc Matos França de. Nascimento por cesariana e adiposidade central em adolescentes de uma coorte de nascimentos (RPS) de uma capital do nordeste brasileiro. 2018. 156 f. Dissertação (Mestrado em Saúde Coletiva) - Universidade Federal do Maranhão, São Luís, 2018.