Al Khalaf Sukainah Y, O'Neill Sinéad M, O'Keeffe Linda M, Henriksen Tine B, Kenny Louise C, Cryan John F, Khashan Ali S
Department of Epidemiology and Public Health, University College Cork, Fourth Floor, Western Gate Building, Cork, Ireland.
Department of Obstetrics and Gynaecology, National Perinatal Epidemiology Centre (NPEC), Cork University Maternity Hospital, Wilton, Cork, Ireland.
Soc Psychiatry Psychiatr Epidemiol. 2015 Oct;50(10):1557-67. doi: 10.1007/s00127-015-1055-9. Epub 2015 Apr 14.
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.
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.
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.
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.
我们研究了分娩方式会影响儿童行为和运动发育这一假设，并检验了是否存在性别特异性关联，即男性和女性的风险评估是否不同。
随机选取2007年12月至2008年5月间出生婴儿的家庭（N = 11134），招募其参与爱尔兰成长研究。分娩方式分为自然阴道分娩、器械助产阴道分娩、急诊剖宫产和择期剖宫产。9个月大时完成《年龄与发育进程问卷》，3岁时完成《长处与困难问卷》。对数据进行加权以代表全国样本（N = 73662），并使用多因素逻辑回归进行统计分析。
在9个月大时，择期剖宫产与个人社交技能延迟相关[调整优势比，aOR 1.24；（95%置信区间，CI 1.04，1.48）]以及粗大运动功能延迟相关[aOR 1.62，（95%CI 1.34，1.96）]，而急诊剖宫产与粗大运动功能延迟相关[aOR 1.30，（95%CI 1.06，1.59）]。在3岁时，所有分娩方式下总优势和困难问卷（SDQ）得分异常的风险均未显著增加。
择期剖宫产出生的儿童在9个月大时可能面临认知和运动发育延迟。所有分娩方式下均未发现总SDQ得分增加。需要进一步研究以在其他人群中重复这些发现，并探索潜在的生物学机制。
