Effects on developmental outcomes after cesarean birth versus vaginal birth in Chinese children aged 1-59 months: a cross-sectional community-based survey.

Hong Zhou,Xi Wang,Yue Huang,Yuan Ding,Xiaona Huang,Yan Wang,Xueqi Qu,Xintong Li,Yuning Yang,Siyu Zou,Anqi Wang

doi:10.7717/peerj.7902

Hong Zhou, Xi Wang + Show 9 more

Open Access

https://doi.org/10.7717/peerj.7902

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Journal: PeerJ	Publication Date: Oct 23, 2019
Citations: 5	License type: CC BY 4.0

Affiliation: Peking University, University of Southern California

Abstract

ObjectiveIt 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.MethodsData were collected from a cross-sectional community-based survey, which recruited 1,755 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.ResultsThe 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).ConclusionsOur findings suggest that cesarean delivery does not increase or decrease the risk of suspected developmental in children delay as compared with vaginal delivery.

Highlights

According to published data from 150 countries in 1990–2014 (Betran et al, 2016), the global cesarean section rate rose to 18.6%, which was higher than the 15% recommended cesarean section rate proposed by WHO in 1985 (1985)
Our study shows that there is no significant difference in neurodevelopmental behaviors between cesarean and vaginal-delivered children
The abnormal ASQ rate was a reflection of developmental delay in children, but we did not find any significant difference in general result or each ASQ domain between the two groups of children

Summary

Introduction

According to published data from 150 countries in 1990–2014 (Betran et al, 2016), the global cesarean section rate rose to 18.6%, which was higher than the 15% recommended cesarean section rate proposed by WHO in 1985 (1985). With the development of perinatal care, the safety of cesarean section has been greatly improved, and cesarean section plays an important role in reducing maternal and neonatal mortality. When cesarean section rate rose from less than 5% to 10%, the cesarean section rate was significantly associated with the decreased maternal and neonatal mortality, especially in low-income countries where cesarean section was not available (Althabe et al, 2006). Once cesarean section rate reached 10%, its further increased rate is not associated with a reduction of maternal, neonatal, and infant mortality rates (Ye et al, 2014)

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Conclusion