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Does cesarean delivery increase the occurrence of neurodevelopmental disorders in childhood?

Ginden Chen1,2, Wan-Lin Chiang3, Tung-Liang Chiang4

  • 1Department of Obstetrics and Gynecology, Chung Shan Medical University Hospital, Taichung, Taiwan.

International Journal of Gynaecology and Obstetrics: the Official Organ of the International Federation of Gynaecology and Obstetrics
|December 3, 2021
PubMed

Insights

Cesarean delivery (CD) may be linked to a slightly increased risk of neurodevelopmental disorders (NDDs). Emergency CD showed a higher association, though this risk was reduced after accounting for factors like gestational age and maternal/child characteristics.

Area of Science:

  • Pediatric Health
  • Neuroscience
  • Obstetrics

Background:

  • Cesarean delivery (CD) is a common birth mode, and understanding its long-term effects on child development is crucial.
  • Neurodevelopmental disorders (NDDs) represent a significant public health concern, impacting children's cognitive and behavioral outcomes.
  • Previous research has suggested potential links between delivery mode and child health, but further investigation is warranted.

Purpose of the Study:

  • To examine the association between cesarean delivery (CD) and the incidence of neurodevelopmental disorders (NDDs) in children at 8 years of age.
  • To investigate specific CD modalities and their relationship with NDD occurrence.
  • To explore potential confounding factors influencing the CD-NDD association.

Main Methods:

  • Utilized data from 19,142 children in the Taiwan Birth Cohort Study (TBCS).
  • Analyzed associations between delivery modes (vaginal vs. CD, including emergency CD) and NDDs.
  • Controlled for gestational age (GA), birth condition, child characteristics, and maternal factors.

Main Results:

  • Cesarean delivery (CD) was associated with a 1.15 odds ratio (OR) for NDDs (95% CI: 1.00-1.32).
  • Emergency CD showed a higher OR of 1.38 (95% CI: 1.16-1.65) compared to vaginal delivery.
  • Associations were attenuated after adjusting for GA and other covariates, with GA demonstrating a significant inverse dose-effect.

Conclusions:

  • Delivery mode and gestational age (GA) appear to influence childhood NDD occurrence.
  • The risk association between delivery mode and NDDs may be modified by factors such as male sex, lower socioeconomic status, and maternal gestational diabetes mellitus.
Abstract

Keywords:
cesarean deliverycesarean sectionneurodevelopmental disordersvaginal delivery

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