Changes in Maternal Plasma Adiponectin from Late Pregnancy to the Postpartum Period According to the Mode of Delivery: Results from a Prospective Cohort in Rio de Janeiro, Brazil

Abstract

IntroductionMaternal plasma adiponectin is inversely related to insulin resistance, atherosclerosis and child health. However, little is known about its concentrations in the perinatal period, especially according to mode of delivery. Our aim is to evaluate the association between mode of delivery and changes in maternal plasma adiponectin from 3rd trimester of pregnancy to 30–45 days postpartum.MethodsA cohort was recruited in Rio de Janeiro, Brazil, with four waves of follow-up: 5-13th, 22-26th, 30-36th gestational weeks and 30–45 days postpartum. Eligible subjects should be between 20–40 years of age, be free of chronic and infectious diseases and presenting with a singleton pregnancy. The mode of delivery was classified as vaginal (VD) or cesarean (CS). Plasma adiponectin concentration (μg/mL) was measured using commercial ELISA kits. Statistical analyses included the Wilcoxon rank-sum test and the multiple linear mixed effects model.ResultsA total of 159 participated in the study. Median adiponectin concentrations were higher for the VD group (n = 99; 8.25, IQR: 5.85–11.90) than for the CS group (n = 60; 7.34, IQR: 4.36–9.76; p = 0.040) in the postpartum samples but were not different between the two groups in the 3rd trimester. Women who underwent CS had a lower rate of increase in adiponectin concentration from the 3rd trimester to 30–45 days postpartum compared to those who underwent VD (β = -.15, 95% CI: -.28-.02, p = 0.030).ConclusionThe CS procedure was associated with lower maternal circulating concentrations of adiponectin at 30–45 days postpartum, compared to the VD.

Adiponectin levels in maternal serum and umbilical cord blood at birth by mode of delivery: relationship to anthropometric measurements and fetal sex

“…Nevertheless, the mode of delivery did not have statistical effects on umbilical cord blood adiponectin concentrations. A similar result was obtained in Brazil, where the adiponectin concentrations were reported higher in the vaginal delivery group [18].…”

“…In recent years, the rate of cesarean section (C-section) deliveries is suggestive of an increasing trend worldwide [17]. C-section as a surgical procedure is usually extremely stressful experience which can lead to an inflammatory situation and change the concentration of adiponectin [18]. The results of a systematic review revealed that C-section is associated with an increased risk of type-1 diabetes, asthma and metabolic syndrome as long-term outcomes [19].…”

Maternal Microbiota, Cortisol Concentration, and Post-Partum Weight Recovery Are Dependent on Mode of Delivery

“…Recently, Koren et al demonstrated that the progesterone concentration could influence the relative abundance of Bifidobacterium in the maternal gut microbiota [95]. Further, Rebelo et al identified differences in the adiponectin concentration according to the mode of birth, with CS delivery being associated with a lower adiponectin concentration than VAG delivery at 30-45 days post-partum, which was likely mediated by the long-term inflammation associated with the CS procedure [96].…”

Maternal omentin-1 level, quality of life and marital satisfaction in relation to mode of delivery: a prospective cohort study

“…Moreover, cesarean section is associated with an increased risk of asthma, allergies, type 2 diabetes, celiac disease [9] and obesity risks during adulthood [10]. Both cesarean sections and vaginal delivery are known as an inflammatory processes which can lead to changes in the level of anti-inflammatory adipokines [11,12].…”