Peer Review #1 of "Effects on developmental outcomes after cesarean birth versus vaginal birth in Chinese children aged 1–59 months: a cross-sectional community-based survey (v0.1)"

Abstract

It is controversial whether the mode of delivery is associated with developmental outcome, and little was known about growth and development of cesarean children in poor rural areas in China. We aim to measure the development of both cesarean and vaginal-delivered children by Ages and Stages Questionnaires (ASQ) and explore the association between mode of delivery and developmental outcome in poor rural areas in China. METHODS: Data were collected from a cross-sectional community-based survey, which recruited 1755 vaginal delivered and cesarean children ages 1 to 59 months in eight counties of China. Caregivers of those children completed the Chinese version of ASQ-3 (ASQ-C) while physical examination andquestionnaires on socio-demographic and neonatal characteristics were conducted. Multivariate logistic regressions were used to measure the association between developmental delay and mode of delivery as well as each socio-demographic factor, respectively, after adjusting other socio-demographic characteristics. RESULTS: The prevalence of suspected overall developmental delay was 23.4% in the cesarean group, compared with 21.3% in the vaginal delivered group, yet without statistical difference (p>0.05). Developmental delay was also not significantly different between cesarean and vaginal delivered group in five ASQ domains of communication (7.7% vs. 7.8%, p=0.949), fine motor (7.0% vs. 6.1%, p=0.538), gross motor (8.5% vs. 6.4%, p=0.154), problem solving (7.2% vs. 6.7%, p=0.722) and personal social (8.0% vs. 7.9%, p=0.960). CONCLUSIONS: Our findings suggest that cesarean delivery does not increase or decrease the risk of suspected developmental in children delay as compared with vaginal delivery.