Evidence map›Paper›PMID 39032311›Full record

ArticleEuropean journal of obstetrics, gynecology, and reproductive biology2024

Mode of delivery predicts postpartum maternal leukocyte telomere length.

Danielle M Panelli, Jonathan A Mayo, Ronald J Wong, Martin Becker, Dorien Feyaerts, Ivana Marić, Erica Wu, Ian H Gotlib, Brice Gaudillière, Nima Aghaeepour and 4 more

Erratum issuedAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in European journal of obstetrics, gynecology, and reproductive biology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

14 authors.

Danielle M PanelliDivision of Maternal-Fetal Medicine and Obstetrics, Department of Obstetrics and Gynecology, Stanford University, Stanford, CA, USA. Electronic address: dpanelli@stanford.edu.
Jonathan A MayoDivision of Maternal-Fetal Medicine and Obstetrics, Department of Obstetrics and Gynecology, Stanford University, Stanford, CA, USA.
Ronald J WongDepartment of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA.
Martin BeckerDepartment 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.
Dorien FeyaertsDepartment of Anesthesiology, Perioperative, and Pain Medicine, Stanford University School of Medicine, Stanford, CA, USA.
Ivana MarićDepartment of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA.
Erica WuDivision of Maternal-Fetal Medicine and Obstetrics, Department of Obstetrics and Gynecology, Stanford University, Stanford, CA, USA.
Ian H GotlibDepartment of Psychology, Stanford University, Stanford, CA, USA.
Brice GaudillièreDepartment of Anesthesiology, Perioperative, and Pain Medicine, Stanford University School of Medicine, Stanford, CA, USA.
Nima AghaeepourDepartment of Anesthesiology, Perioperative, and Pain Medicine, Stanford University School of Medicine, Stanford, CA, USA; Department of Biomedical Data Science, Stanford University, Stanford, CA, USA.
Maurice L DruzinDivision of Maternal-Fetal Medicine and Obstetrics, Department of Obstetrics and Gynecology, Stanford University, Stanford, CA, USA.
David K StevensonDepartment of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA.
Gary M ShawDepartment of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA.
Katherine BiancoDivision of Maternal-Fetal Medicine and Obstetrics, Department of Obstetrics and Gynecology, Stanford University, Stanford, CA, USA.

Funding

Psychobiological Mechanisms Underlying the Association Between Early Life Stress and Depression Across AdolescenceR37MH101495 · NIMH · STANFORD UNIVERSITY · PI IAN H GOTLIB · 2018 to 2026
$6.6M
Machine Learning for Integrative Modeling of the Immune System in Clinical SettingsR35GM138353 · NIGMS · STANFORD UNIVERSITY · PI AGHAEEPOUR, NIMA · 2020 to 2024
$2.2M
Stanford Women's Reproductive Health Research Career Development ProgramK12HD103084 · NICHD · STANFORD UNIVERSITY · PI LESLEE L SUBAK · 2020 to 2026
$2.2M
NICHD NIH HHS K12 HD103084NIGMS NIH HHS R35 GM138353NIMH NIH HHS R37 MH101495
6 · The paper itself

Abstract

backgroundRecent 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

designPostpartum 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).

resultsOf 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.

conclusionMaternal 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.

Indexed as

Cesarean SectionDelivery, ObstetricLeukocytesPostpartum PeriodAdultFemaleHumansPregnancyProspective StudiesTelomereAgingBiologic agingBirthCesareanChildbirthInflammationMachine learningMultiomicPostpartumPregnancyTelomeresVaginal delivery

Identifiers

PMID39032311
PMCPMC11347108

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.