Operative vaginal delivery and third grade educational outcomes.

Area of Science:

• Obstetrics and Gynecology
• Pediatric Health
• Educational Outcomes

Background:

• Operative vaginal delivery rates are declining due to safety concerns.
• Previous research indicates short-term neonatal outcomes are not negatively affected by operative vaginal delivery.

Purpose of the Study:

• To investigate the association between mode of delivery and long-term childhood educational outcomes.
• To provide evidence to inform clinical decision-making regarding operative vaginal delivery versus cesarean delivery.

Main Methods:

• Retrospective cohort study linking birth certificate data with third-grade educational data in Rhode Island.
• Analysis included term, singleton births without congenital anomalies, comparing spontaneous vaginal, operative vaginal, and primary cesarean deliveries.
• Multivariable log-binomial regression adjusted for confounders like gestational age, sex, race/ethnicity, and socioeconomic status.

Main Results:

• No significant difference in third-grade reading or math proficiency was found between children born via operative vaginal delivery and primary cesarean delivery.
• Similarly, spontaneous vaginal delivery showed no significant difference in educational outcomes compared to primary cesarean delivery.
• Adjusted risk ratios for reading and math proficiency were consistently near 1.0 across comparisons.

Conclusions:

• Operative vaginal delivery is not associated with adverse long-term educational outcomes in children.
• This evidence can help alleviate concerns regarding the safety of operative vaginal delivery.
• Findings support shared decision-making between providers and patients when considering delivery mode.