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Prelabour caesarean section and neurodevelopmental outcome at 4 and 12 months of age: an observational study
Mehreen Zaigham1, Lena Hellström-Westas2, Magnus Domellöf3
1Department of Obstetrics & Gynaecology, Lund University and Skåne University Hospital, 205 01, Malmö, Sweden. mehreen.zaigham@med.lu.se.
Insights
Infants born via prelabour caesarean section showed poorer neurodevelopmental outcomes at 4 months compared to vaginally born infants. These differences persisted in gross-motor skills at 12 months, indicating potential early developmental impacts.
Area of Science:
- Obstetrics and Gynecology
- Pediatrics
- Developmental Psychology
Background:
- Global rise in prelabour caesarean section rates.
- Existing evidence suggests negative childhood cognitive outcomes.
- Need to assess short-term neurodevelopmental effects of prelabour caesarean section.
Purpose of the Study:
- To evaluate short-term neurodevelopmental outcomes in infants born via prelabour caesarean section.
- To compare these outcomes with infants born via non-instrumental vaginal delivery.
Main Methods:
- Prospective, observational study design.
- Inclusion of infants delivered by prelabour caesarean section (n=66).
- Comparison with a historical cohort of vaginally born infants (n=352).
- Follow-up assessments at 4 and 12 months using Ages and Stages Questionnaire, second edition (ASQ-II).
Main Results:
- Prelabour caesarean infants had significantly lower ASQ-II total scores at 4 months across all domains (communication, gross motor, fine motor, problem-solving, personal-social).
- Adjusted mean difference in ASQ-II total score was -20.7 (95% CI: -28.7 to -12.6) compared to vaginally born infants.
- Gross-motor skill deficits persisted at 12 months (adjusted mean difference: -4.7; 95% CI: -8.8 to -0.7).
Conclusions:
- Adverse neurodevelopmental outcomes may be detectable in infants born by prelabour caesarean section within months of birth.
- Further research is necessary to fully understand this relationship.
- Findings highlight potential early developmental impacts of prelabour caesarean delivery.
Background:
With prelabour caesarean section rates growing globally, there is direct and indirect evidence of negative cognitive outcomes in childhood. The objective of this study was to assess the short-term neurodevelopmental outcomes after prelabour caesarean section as compared to vaginally born infants.
Methods:
We conducted a prospective, observational study of infants delivered by prelabour caesarean section at the Hospital of Halland, Halmstad, Sweden and compared their development with an historical group of infants born by non-instrumental vaginal delivery.
Results:
Infants born by prelabour caesarean section were compared with a group of vaginally born infants. Follow-up assessments were performed at 4 and 12 months. Prelabour caesarean infants (n = 66) had significantly lower Ages and Stages Questionnaire, second edition (ASQ-II) scores in all domains (communication, gross motor, fine motor, problem solving and personal-social) at 4 months of age with an adjusted mean difference (95% CI) of - 20.7 (- 28.7 to - 12.6) in ASQ-II total score as compared to vaginally born infants (n = 352). These differences remained for gross-motor skills at the 12 month assessment, adjusted mean difference (95% CI) -4.7 (- 8.8 to - 0.7), n = 62 and 336.
Conclusions:
Adverse neurodevelopmental outcomes in infants born by prelabour caesarean section may be apparent already a few months after birth. Additional studies are warranted to explore this relationship further.
