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The impact of obstetric mode of delivery on childhood behavior

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Abstract

Purpose

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.

Methods

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.

Results

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.

Conclusions

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.

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Acknowledgments

The Growing Up in Ireland data have been funded by the Government of Ireland through the Department of Children and Youth Affairs and have been collected under the Statistics Act, 1993 of the Central Statistics Office. The project has been designed and implemented by the joint Economic and Social Research Institute (ERSI) and Trinity College Dublin (TCD) Growing Up in Ireland Study Team. This work was supported by the Masters in Public Health Programme Team, University College Cork, Cork, Ireland.

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The authors have no conflict of interest to declare.

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Correspondence to Linda M. O’Keeffe or Ali S. Khashan.

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Khalaf, S.Y.A., O’Neill, S.M., O’Keeffe, L.M. et al. The impact of obstetric mode of delivery on childhood behavior. Soc Psychiatry Psychiatr Epidemiol 50, 1557–1567 (2015). https://doi.org/10.1007/s00127-015-1055-9

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  • DOI: https://doi.org/10.1007/s00127-015-1055-9

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