Department of Psychological Medicine, University of Auckland, Auckland, New Zealand.
A Better Start - National Science Challenge, University of Auckland, Auckland, New Zealand.
Aust N Z J Obstet Gynaecol. 2021 Jun;61(3):386-393. doi: 10.1111/ajo.13276. Epub 2020 Nov 25.
Birth by caesarean section has been shown to alter the composition of the early infant gut microbiota and postulated to influence cognitive outcomes via the gut-brain axis.
To determine whether birth by caesarean section is associated with secondary school educational achievement.
Whole-population administrative data were used from anonymised individual level linkage of birth records to educational and health information from the New Zealand Integrated Data Infrastructure (IDI). Participants were 111 843 children born between 1 January 1996 and 31 December 1998 for whom mode of delivery information was available from International Classification of Diseases 9th edition codes in maternal records. The National Certificate of Educational Achievement (NCEA) is the main secondary school qualification undertaken by New Zealand students. Multivariable linear regression models were used to examine the association between mode of delivery and educational achievement. A family fixed effect analysis compared educational achievement outcomes in sibling pairs where one sibling was delivered by caesarean section and one delivered vaginally.
After adjustment for potential confounders, there was no significant association between mode of delivery and achievement of university entrance (odds ratio = 0.98, 95% CI: 0.94-1.02). NCEA percentile scores were lower in caesarean born infants (Estimate = -0.37, 95% CI: -0.69 to -0.06)). However, in the fixed effect sibling analysis caesarean section was no longer significantly associated with NCEA percentile scores.
We find that caesarean section is not related to educational outcomes, suggesting that even if the infant gut microbiota is altered in caesarean section, it does not appear to have a measurable impact on adolescent academic achievement.
剖宫产已被证明会改变婴儿早期肠道微生物群的组成，并通过肠道-大脑轴来影响认知结果。
确定剖宫产是否与中学教育成就相关。
利用新西兰综合数据基础设施（IDI）中匿名个体水平链接的出生记录和教育及健康信息的全人群行政数据。参与者为 1996 年 1 月 1 日至 1998 年 12 月 31 日期间出生的 111843 名儿童，他们的分娩方式信息可从母亲记录的国际疾病分类第 9 版代码中获得。国家教育成就证书（NCEA）是新西兰学生主要的中学资格证书。使用多变量线性回归模型来检验分娩方式与教育成就之间的关系。采用家庭固定效应分析比较了一个兄弟姐妹通过剖宫产分娩，另一个通过阴道分娩的兄弟姐妹的教育成就结果。
在调整了潜在混杂因素后，分娩方式与进入大学的机会（优势比=0.98，95%CI：0.94-1.02）之间没有显著关联。剖宫产出生的婴儿的 NCEA 百分位数较低（估计值=-0.37，95%CI：-0.69 至-0.06）。然而，在固定效应的兄弟姐妹分析中，剖宫产与 NCEA 百分位数之间不再存在显著关联。
我们发现剖宫产与教育结果无关，这表明即使剖宫产改变了婴儿的肠道微生物群，它似乎也不会对青少年的学业成绩产生可衡量的影响。
