Implications of caesarean section for children's school achievement: A population‐based study

Smithers, Lisa G.; Mol, Ben Willem J.; Wilkinson, Chris; Lynch, John

doi:10.1111/ajo.12475

Cited by 17 publications

(16 citation statements)

References 18 publications

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“…Another study of around 1200-3500 Australian children, depending on the outcome considered, reported no differences in child development at the age of 5 years and in school achievement at the age of 8 years between children born by actual VBAC compared with ERCS. 40 Compared with ERCS, our study only found a slight increase in the risk of any SENs and in certain types of SEN with actual VBAC, which might well be attributable to type-1 error or residual confounding. As we are not aware of any clinical reason to explain the reduced risk of language or speech disorder seen only with in-labour non-elective repeat caesarean, compared with ERCS, this finding might also be attributable to type-1 error or residual confounding.…”

Section: Discussioncontrasting

confidence: 61%

Planned mode of birth after previous caesarean section and special educational needs in childhood: a population‐based record linkage cohort study

Fitzpatrick

Kurinczuk

Quigley

2021

BJOG

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Objective To investigate the association between planned mode of birth after previous caesarean section and a child's risk of having a record of special educational needs (SENs).Design Population-based cohort study. Setting Scotland.Population A cohort of 44 892 singleton children born at term in Scotland between 2002 and 2011 to women with one or more previous caesarean sections.Methods Linkage of Scottish national health and education data sets.Main outcome measures Any SENs and specific types of SEN recorded when a child was aged 4-11 years and attending a Scottish primary or special school.Results Children born following planned vaginal birth after previous caesarean (VBAC) compared with elective repeat caesarean section (ERCS) had a similar risk of having a record of any SENs (19.24 versus 17.63%, adjusted risk ratio aRR 1.04, 95% CI 0.99-1.09) or specific types of SEN. There was also little evidence that planned VBAC with or without labour induction compared with ERCS was associated with a child's risk of having a record of any SENs (21.42 versus 17.63%, aRR 1.09, 95% CI 1.01-1.17 and 18.78 versus 17.63%, aRR 1.03, 95% CI 0.98-1.08, respectively) or most types of SEN. However, an increased risk of sensory impairment was seen for planned VBAC with labour induction compared with ERCS (1.18 versus 0.78%, risk difference 0.4%, adjusted odds ratio aOR 1.60, 95% CI 1.09-2.34).Conclusions This study provides little evidence of an association between planned mode of birth after previous caesarean and SENs in childhood beyond a small absolute increased risk of sensory impairment seen for planned VBAC with labour induction. This finding may be the result of performing multiple comparisons or residual confounding. The findings provide valuable information to manage and counsel women with previous caesarean section concerning their future birth choices. Keywords Caesarean section, child outcomes, elective repeat caesarean section (ERCS), mode of birth, special educational needs, trial of labour after previous caesarean (TOLAC), vaginal birth after previous caesarean (VBAC).

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Section: Discussioncontrasting

confidence: 61%

Planned mode of birth after previous caesarean section and special educational needs in childhood: a population‐based record linkage cohort study

Fitzpatrick

Kurinczuk

Quigley

2021

BJOG

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“…Some studies have revealed deficits in cognitive domains [20,21], delayed motor development [22,23], or a higher risk of mental health problems, such as autism and Attention-Deficit/Hyperactivity Disorder (ADHD) [24,25] in children who were born by CS. Some studies, though, found no effects of CS on child psychological outcomes [26][27][28][29] and some have reported positive outcomes [30,31]. These discrepancies might be due to different methodology, such as measurement of outcomes (e.g., parental report or direct child assessment), different sample characteristics, type of CS examined (planned for medical reasons or maternal request, emergency CS), or confounders that are controlled for.…”

Section: Introductionmentioning

confidence: 99%

Associations Between Mode of Birth and Neuropsychological Development in Children Aged 4 Years: Results from a Birth Cohort Study

Takács

Putnam

Monk

et al. 2020

Child Psychiatry Hum Dev

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The aim of this prospective longitudinal study was to examine the association between Cesarean section (CS) and child development and behavior. The sample consisted of 256 children who were born at term without serious perinatal pathologies. Their development and behavior was assessed at the age of four using Ages and Stages Questionnaire (ASQ-3), Children’s Behavior Questionnaire and Strength and Difficulties Questionnaire. Multivariate linear regression analyses were conducted to assess the association between CS and child outcomes. CS was associated with better scores in the Problem Solving domain of the ASQ in the whole sample. After stratifying by child sex, the positive association between CS and the Problem Solving domain was significant in boys, while no association was found in girls. Girls were rated less optimally in the Gross Motor domain of the ASQ when born via CS. Mode of birth was not associated with behavioral outcomes.

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“…In Australia, Smithers et al [ 9 ] analyzed the school assessment of children at the age of 8 years by comparing cesarean section ( n = 650) vs. vaginal birth ( n = 2959) in women with a previous cesarean delivery. The assessment included reading, writing, spelling, grammar, and numeracy.…”

Section: Introductionmentioning

confidence: 99%

The Impact of Cesarean and Vaginal Delivery on Results of Psychological Cognitive Test in 5 Year Old Children

et al. 2020

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Background and objectives: The impact of cesarean and vaginal delivery on cognitive development was analyzed in 5 year old children. Materials and Methods: Two cohorts of 5 year old children born in the years 2013 and 2014 in Karvina (Northern Moravia) and Ceske Budejovice (Southern Bohemia) were studied for their cognitive development related to vaginal (n = 117) and cesarean types of delivery (n = 51). The Bender Visual Motor Gestalt Test (BG test) and the Raven Colored Progressive Matrices (RCPM test) were used as psychological tests. Results: In the comparison of vaginal delivery vs. cesarean section, the children delivered by cesarean section scored lower and, therefore, achieved poorer performance in cognitive tests compared to those born by vaginal delivery, as shown in the RCPM (p < 0.001) and in the BG test (p < 0.001). When mothers’ education level was considered, the children whose mothers achieved a university degree scored higher in both the RCPM test (p < 0.001) and the BG test (p < 0.01) compared to the children of mothers with lower secondary education. When comparing mothers with a university degree to those with higher secondary education, there was a significant correlation between level of education and score achieved in the RCPM test (p < 0.001), but not in the BG test. Conclusions: According to our findings, the mode of delivery seems to have a significant influence on performance in psychological cognitive tests in 5 year old children in favor of those who were born by vaginal delivery. Since cesarean-born children scored notably below vaginally born children, it appears possible that cesarean delivery may have a convincingly adverse effect on children’s further cognitive development.

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Implications of caesarean section for children's school achievement: A population‐based study

Cited by 17 publications

References 18 publications

Planned mode of birth after previous caesarean section and special educational needs in childhood: a population‐based record linkage cohort study

Planned mode of birth after previous caesarean section and special educational needs in childhood: a population‐based record linkage cohort study

Associations Between Mode of Birth and Neuropsychological Development in Children Aged 4 Years: Results from a Birth Cohort Study

The Impact of Cesarean and Vaginal Delivery on Results of Psychological Cognitive Test in 5 Year Old Children

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