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Updated: Dec 15, 2025

Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Early-term elective Caesarean sections did not increase the risk of behavioural problems at six to eight years of age
Trine Muhs Nielsen1, Julie Glavind1,2, Ioanna Milidou1,3
1Perinatal Epidemiology Research Unit, Aarhus University, Aarhus, Denmark.
Aim:
Our aim was to explore the under-researched associations between an elective Caesarean section (C-section) at early-term or full-term gestation and behaviour at 6-8 years of age.
Methods:
We identified 1220 eligible children born by elective C-sections at Danish hospital from 2009 to 2011. Their mothers were randomised to elective C-sections at either 38+3 (early-term) or 39+3 (full-term) weeks of gestation. From December 2017 to August 2018, the parents completed the Strengths and Difficulties Questionnaire. The results were adjusted for maternal education, parity and the child's sex.
Results:
Of the 574 (45%) children followed up, 288 were delivered early-term and 286 were delivered full-term. The groups had similar baseline characteristics. There were no differences in the total difficulties score, subscale scores or the risk of being classified as having a possible or probable psychiatric disorder. Early-term boys had a lower risk of being classified as having a possible or probable psychiatric disorder and early-term girls had higher risk, but the results were not statistically significant.
Conclusion:
We found no difference in behaviour at 6-8 years of age between children born by elective C-section at early- versus full-term gestation.
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