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Mode of delivery predicts postpartum maternal leukocyte telomere length.
Panelli, Danielle M; Mayo, Jonathan A; Wong, Ronald J; Becker, Martin; Feyaerts, Dorien; Maric, Ivana; Wu, Erica; Gotlib, Ian H; Gaudillière, Brice; Aghaeepour, Nima; Druzin, Maurice L; Stevenson, David K; Shaw, Gary M; Bianco, Katherine.
Afiliación
  • Panelli DM; Division of Maternal-Fetal Medicine and Obstetrics, Department of Obstetrics and Gynecology, Stanford University, Stanford, CA, USA. Electronic address: dpanelli@stanford.edu.
  • Mayo JA; Division of Maternal-Fetal Medicine and Obstetrics, Department of Obstetrics and Gynecology, Stanford University, Stanford, CA, USA.
  • Wong RJ; Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA.
  • Becker M; Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University School of Medicine, Stanford, CA, USA; Department of Computer Science and Electrical Engineering, University of Rostock, Germany; Department of Biomedical Data Science, Stanford University, Stanford, CA, USA.
  • Feyaerts D; Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University School of Medicine, Stanford, CA, USA.
  • Maric I; Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA.
  • Wu E; Division of Maternal-Fetal Medicine and Obstetrics, Department of Obstetrics and Gynecology, Stanford University, Stanford, CA, USA.
  • Gotlib IH; Department of Psychology, Stanford University, Stanford, CA, USA.
  • Gaudillière B; Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University School of Medicine, Stanford, CA, USA.
  • Aghaeepour N; Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University School of Medicine, Stanford, CA, USA; Department of Biomedical Data Science, Stanford University, Stanford, CA, USA.
  • Druzin ML; Division of Maternal-Fetal Medicine and Obstetrics, Department of Obstetrics and Gynecology, Stanford University, Stanford, CA, USA.
  • Stevenson DK; Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA.
  • Shaw GM; Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA.
  • Bianco K; Division of Maternal-Fetal Medicine and Obstetrics, Department of Obstetrics and Gynecology, Stanford University, Stanford, CA, USA.
Eur J Obstet Gynecol Reprod Biol ; 300: 224-229, 2024 Sep.
Article en En | MEDLINE | ID: mdl-39032311
ABSTRACT

BACKGROUND:

Recent studies have suggested that pregnancy accelerates biologic aging, yet little is known about how biomarkers of aging are affected by events during the peripartum period. Given that immune shifts are known to occur following surgery, we explored the relation between mode of delivery and postpartum maternal leukocyte telomere length (LTL), a marker of biologic aging. STUDY

DESIGN:

Postpartum maternal blood samples were obtained from a prospective cohort of term, singleton livebirths without hypertensive disorders or peripartum infections between 2012 and 2018. The primary outcome was postpartum LTLs from one blood sample drawn between postpartum week 1 and up to 6 months postpartum, measured from thawed frozen peripheral blood mononuclear cells using quantitative PCR in basepairs (bp). Multivariable linear regression models compared LTLs between vaginal versus cesarean births, adjusting for age, body mass index, and nulliparity as potential confounders. Analyses were conducted in two mutually exclusive groups those with LTL measured postpartum week 1 and those measured up to 6 months postpartum. Secondarily, we compared multiomics by mode of delivery using machine-learning methods to evaluate whether other biologic changes occurred following cesarean. These included transcriptomics, metabolomics, microbiomics, immunomics, and proteomics (serum and plasma).

RESULTS:

Of 67 included people, 50 (74.6 %) had vaginal and 17 (25.4 %) had cesarean births. LTLs were significantly shorter after cesarean in postpartum week 1 (5755.2 bp cesarean versus 6267.8 bp vaginal, p = 0.01) as well as in the later draws (5586.6 versus 5945.6 bp, p = 0.04). After adjusting for confounders, these differences persisted in both week 1 (adjusted beta -496.1, 95 % confidence interval [CI] -891.1, -101.1, p = 0.01) and beyond (adjusted beta -396.8; 95 % CI -727.2, -66.4. p = 0.02). Among the 15 participants who also had complete postpartum multiomics data available, there were predictive signatures of vaginal versus cesarean births in transcriptomics (cell-free [cf]RNA), metabolomics, microbiomics, and proteomics that did not persist after false discovery correction.

CONCLUSION:

Maternal LTLs in postpartum week 1 were nearly 500 bp shorter following cesarean. This difference persisted several weeks postpartum, even though other markers of inflammation had normalized. Mode of delivery should be considered in any analyses of postpartum LTLs and further investigation into this phenomenon is warranted.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Cesárea / Parto Obstétrico / Periodo Posparto / Leucocitos Límite: Adult / Female / Humans / Pregnancy Idioma: En Revista: Eur J Obstet Gynecol Reprod Biol Año: 2024 Tipo del documento: Article Pais de publicación: Irlanda

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Cesárea / Parto Obstétrico / Periodo Posparto / Leucocitos Límite: Adult / Female / Humans / Pregnancy Idioma: En Revista: Eur J Obstet Gynecol Reprod Biol Año: 2024 Tipo del documento: Article Pais de publicación: Irlanda