The impact of obstetric mode of delivery on childhood behavior.

Khalaf, Sukainah; O'Neill, Sinéad; O'Keeffe, Linda; Henriksen, Tine; Kenny, Louise; Cryan, John; Khashan, Ali; Khalaf, Sukainah Y Al; O'Neill, Sinéad M; O'Keeffe, Linda M; Henriksen, Tine B; Kenny, Louise C; Cryan, John F; Khashan, Ali S; Al Khalaf, Sukainah Y

<bold>Purpose: </bold>We investigated the hypothesis that mode of delivery affects childhood behavior and motor development and examined whether there are sex-specific associations, i.e., whether males and females have different risk estimates.<bold>Methods: </bold>Families with infants born between December 2007 and May 2008 (N = 11,134) were randomly selected and recruited to the Growing Up in Ireland study. Mode of delivery was classified into spontaneous vaginal delivery; instrumental vaginal delivery; emergency Cesarean section (CS); and elective CS. The 'Ages and Stages Questionnaire' was completed at age 9-months and the 'Strengths and Difficulties Questionnaire' at 3 years. Data were weighted to represent the national sample (N = 73,662) and multivariate logistic regression was used for the statistical analyses.<bold>Results: </bold>At age 9 months, elective CS was associated with a delay in personal social skills [adjusted odds ratio, aOR 1.24; (95% confidence interval, CI 1.04, 1.48)] and gross motor function [aOR 1.62, (95% CI 1.34, 1.96)], whereas emergency CS was associated with delayed gross motor function [aOR 1.30, (95% CI 1.06, 1.59)]. At age 3 years there was no significantly increased risk of an abnormal total SDQ score across all modes of delivery.<bold>Conclusions: </bold>Children born by elective CS may face a delay in cognitive and motor development at age 9 months. No increase in total SDQ score was found across all modes of delivery. Further investigation is needed to replicate these findings in other populations and explore the potential biological mechanisms.

IRELAND; OBSTETRICS; MOTOR ability in children; BEHAVIOR disorders in children; CHILDBIRTH; CESAREAN section; COGNITIVE ability; CHILD psychology; CHILD development; CHILD behavior; DELIVERY (Obstetrics); EMERGENCY medical services; LONGITUDINAL method; MOTOR ability; MULTIVARIATE analysis; QUESTIONNAIRES; SEX distribution; ELECTIVE surgery; LOGISTIC regression analysis

Social Psychiatry & Psychiatric Epidemiology, 2015, Vol 50, Issue 10, p1557

0933-7954

Academic Journal

10.1007/s00127-015-1055-9