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Huh, Susanna

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Huh

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Susanna

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Huh, Susanna

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2008 - 200912010 - 20121

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Author's Publications: search.filters.isAuthorOfPublication.0e437d7c-b672-4542-aceb-9fb82ddbf685

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    Delivery by caesarean section and risk of obesity in preschool age children: A prospective cohort study
    (BMJ, 2012) Huh, Susanna; Rifas-Shiman, Sheryl; Zera, Chloe; Edwards, Janet W. Rich; Oken, Emily; Weiss, Scott; Gillman, Matthew
    Objective: To examine whether delivery by caesarean section is a risk factor for childhood obesity. Design: Prospective pre-birth cohort study (Project Viva). Setting: Eight outpatient multi-specialty practices based in the Boston, Massachusetts area. Participants: We recruited women during early pregnancy between 1999 and 2002, and followed their children after birth. We included 1255 children with body composition measured at 3 years of age. Main outcome measures: Body mass index (BMI) z-score, obesity (BMI for age and sex ≥ 95th percentile), and sum of triceps + subscapular skinfold thicknesses, at 3 years of age. Results: 284 children (22.6 percent) were delivered by caesarean section. At age 3, 15.7% of children delivered by caesarean section were obese, compared with 7.5% of children born vaginally. In multivariable logistic and linear regression models adjusting for maternal pre-pregnancy BMI, birth weight, and other covariates, birth by caesarean section was associated with a higher odds of obesity at age 3 (OR 2.10, 95%CI 1.36 to 3.23), higher mean BMI z-score (0.20 units, 95% CI 0.07 to 0.33), and higher sum of triceps + subscapular skinfold thicknesses (0.94 mm, 95% CI 0.36 to 1.51). Conclusions: Infants delivered by caesarean section may be at increased risk of childhood obesity. Further studies are needed to confirm our findings and to explore mechanisms underlying this association.
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    Association between umbilical cord glucocorticoids and blood pressure at age 3 years
    (BioMed Central, 2008) Huh, Susanna; Andrew, Ruth; Rich-Edwards, Janet; Kleinman, Kenneth Paul; Seckl, Jonathan R; Gillman, Matthew
    Background: Animal data show that decreased activity of placental 11-beta-hydroxysteroid dehydrogenase type 2 (11β-HSD2), which potently inactivates glucocorticoids (e.g. cortisol) to inert forms (cortisone), allows increased access of maternal glucocorticoids to the fetus and 'programs' hypertension. Data in humans are limited. We examined in humans the association between venous umbilical cord blood glucocorticoids, a potential marker for placental 11β-HSD2 enzyme activity, and blood pressure at age 3 years. Methods: Among 286 newborns in Project Viva, a prospective pre-birth cohort study based in eastern Massachusetts, we measured cortisol (F) and cortisone (E) in venous cord blood and used the ratio of F/E as a marker for placental 11β-HSD2 activity. We measured blood pressure (BP) when the offspring reached age 3 years. Using mixed effects regression models to control for BP measurement conditions, maternal and child characteristics, we examined the association between the F/E ratio and child BP. Results: At age 3 years, each unit increase in the F/E ratio was associated with a 1.6 mm Hg increase in systolic BP (95% CI 0.0 to 3.1). The F/E ratio was not associated with diastolic blood pressure or birth weight for gestational age z-score. Conclusion: A higher F/E ratio in umbilical venous cord blood, likely reflecting reduced placental 11β-HSD2 activity, was associated with higher systolic blood pressure at age 3 years. Our data suggest that increased fetal exposure to active maternal glucocorticoids may program later systolic blood pressure.