Research Review: Birth by caesarean section and development of autism spectrum disorder and attention-deficit/hyperactivity disorder: a systematic review and meta-analysis.

Curran, Eileen A.; O'Neill, Sinéad M.; Cryan, John F.; Kenny, Louise C.; Dinan, Timothy G.; Khashan, Ali S.; Kearney, Patricia M.

Background Given the growing prevalence of birth by Caesarean section ( CS) worldwide, it is important to understand any long-term effects CS delivery may have on a child's development. We assessed the impact of mode of delivery on autism spectrum disorders ( ASD) and attention-deficit/hyperactivity disorder ( ADHD). Methods We conducted a systematic review of the literature in PubMed, Embase, CINAHL, Psyc INFO and Web of Science up to 28 February 2014. No publication date, language, location or age restrictions were employed. Results Thirteen studies reported an adjusted estimate for CS- ASD, producing a pooled odds ratio ( OR) of 1.23 (95% CI: 1.07, 1.40). Two studies reported an adjusted estimate for CS- ADHD, producing a pooled OR of 1.07 (95% CI: 0.86, 1.33). Conclusions Delivery by CS is associated with a modest increased odds of ASD, and possibly ADHD, when compared to vaginal delivery. Although the effect may be due to residual confounding, the current and accelerating rate of CS implies that even a small increase in the odds of disorders, such as ASD or ADHD, may have a large impact on the society as a whole. This warrants further investigation.

ATTENTION-deficit hyperactivity disorder; AUTISM; CESAREAN section; CHILD development; CINAHL database; CONFIDENCE intervals; MEDICAL information storage & retrieval systems; PSYCHOLOGY information storage & retrieval systems; MEDLINE; META-analysis; ONLINE information services; SYSTEMATIC reviews; DATA analysis software; ODDS ratio

Journal of Child Psychology & Psychiatry, 2015, Vol 56, Issue 5, p500

0021-9630

Academic Journal

10.1111/jcpp.12351