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  1. Home
  3. Maternal Cesarean Section And Offspring Asd Or Adhd Risk: A Nurses' Health Study Ii Analysis.
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  3. Maternal Cesarean Section And Offspring Asd Or Adhd Risk: A Nurses' Health Study Ii Analysis.

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Maternal Cesarean Section and Offspring ASD or ADHD Risk: A Nurses' Health Study II Analysis.

Jingyuan Xiao1,2, Hayon Michelle Choi3, Gyeyoon Yim4

  • 1Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT, United States.

American Journal of Epidemiology
|June 27, 2026

View abstract on PubMed

Summary
This summary is machine-generated.

Cesarean delivery does not increase the risk of autism spectrum disorder (ASD) or attention-deficit/hyperactivity disorder (ADHD) in children. This large study found no association between delivery mode and these neurodevelopmental outcomes.

Keywords:
cesarean deliveryneurodevelopmentpregnancy

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Area of Science:

  • Neuroscience
  • Epidemiology
  • Pediatrics

Background:

  • Inconsistent epidemiological evidence exists regarding cesarean delivery's impact on offspring neurodevelopment.
  • Previous studies have yielded conflicting results on the association between cesarean birth and neurodevelopmental disorders.

Purpose of the Study:

  • To investigate the association between maternal cesarean delivery and the risk of childhood autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD).

Main Methods:

  • Utilized data from the Nurses' Health Study II cohort, including 29,352 mothers for ASD and 27,704 for ADHD.
  • Employed generalized estimating equations to analyze the odds ratios (OR) and 95% confidence intervals (CI) for child outcomes.
  • Conducted analyses adjusting for numerous confounding factors, including maternal history and sibling comparisons.

Main Results:

  • Fully adjusted models showed no statistically significant association between cesarean delivery and childhood ASD (OR=1.02, 95% CI 0.81-1.29).
  • Similarly, no significant association was found between cesarean delivery and childhood ADHD (OR=1.06, 95% CI 0.95-1.18).
  • Sensitivity analyses, including sibling comparisons, did not alter these primary findings.

Conclusions:

  • The study does not support the hypothesis that cesarean delivery increases the risk for autism spectrum disorder or attention-deficit/hyperactivity disorder.
  • Findings suggest that mode of delivery is unlikely to be a significant risk factor for these common neurodevelopmental conditions.