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Association between Cesarean section and neurodevelopmental disorders in a Japanese birth cohort: the Japan

Taketoshi Yoshida1, Kenta Matsumura2,3, Takehiro Hatakeyama3

  • 1Division of Neonatology, Maternal and Perinatal Center, Toyama University Hospital, 2630 Sugitani, Toyama City, 930-0194, Japan. ytake@med.u-toyama.ac.jp.

BMC Pediatrics
|June 18, 2023
PubMed

Insights

Cesarean section (CS) birth is linked to a higher risk of autism spectrum disorder (ASD) in toddlers. This association was particularly noted in females, suggesting they may be more sensitive to CS delivery effects.

Area of Science:

  • Pediatric Neurodevelopment
  • Obstetrics and Gynecology
  • Epidemiology

Background:

  • Growing interest in long-term effects of Cesarean section (CS) on child neurodevelopment.
  • Previous research indicates sex-based differences in neurodevelopmental disorder prevalence, such as autism spectrum disorder (ASD).

Purpose of the Study:

  • To examine associations between delivery mode (CS vs. vaginal) and neurodevelopmental disorders in toddlers.
  • To investigate these associations separately in male and female toddlers, considering sex-specific risks.

Main Methods:

  • Analysis of 65,701 mother-toddler pairs from the Japan Environment and Children's Study.
  • Logistic regression models used to calculate adjusted odds ratios (aORs) for neurodevelopmental disorders (motor delay, intellectual disability, ASD) at age 3.
  • Stratified analysis by sex to identify gender-specific risks associated with CS delivery.

Main Results:

  • Higher ASD morbidity observed in toddlers delivered via CS compared to vaginal delivery (aOR 1.38).
  • No significant CS-related differences found for motor delay or intellectual disability overall.
  • In females, CS was associated with increased risks for motor delay (aOR 1.88) and ASD (aOR 1.82); no such associations were found in males.

Conclusions:

  • Evidence suggests significant associations between delivery mode and early childhood neurodevelopmental disorders.
  • Female toddlers appear more susceptible to potential neurodevelopmental effects of Cesarean section compared to males.
Abstract

Keywords:
Autism spectrum disorderIntellectual disabilityMode of deliveryMotor delaySex difference

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