Abstract
BackgroundWith prelabour caesarean section rates growing globally, there is direct and indirect evidence of negative cognitive outcomes in childhood. The objective of this study was to assess the short-term neurodevelopmental outcomes after prelabour caesarean section as compared to vaginally born infants.MethodsWe conducted a prospective, observational study of infants delivered by prelabour caesarean section at the Hospital of Halland, Halmstad, Sweden and compared their development with an historical group of infants born by non-instrumental vaginal delivery.ResultsInfants born by prelabour caesarean section were compared with a group of vaginally born infants. Follow-up assessments were performed at 4 and 12 months. Prelabour caesarean infants (n = 66) had significantly lower Ages and Stages Questionnaire, second edition (ASQ-II) scores in all domains (communication, gross motor, fine motor, problem solving and personal-social) at 4 months of age with an adjusted mean difference (95% CI) of − 20.7 (− 28.7 to − 12.6) in ASQ-II total score as compared to vaginally born infants (n = 352). These differences remained for gross-motor skills at the 12 month assessment, adjusted mean difference (95% CI) -4.7 (− 8.8 to − 0.7), n = 62 and 336.ConclusionsAdverse neurodevelopmental outcomes in infants born by prelabour caesarean section may be apparent already a few months after birth. Additional studies are warranted to explore this relationship further.
Highlights
With prelabour caesarean section rates growing globally, there is direct and indirect evidence of negative cognitive outcomes in childhood
In research on delayed cord clamping in vaginal births, improved brain myelin content is present at 4 and 12 months [14, 15], but neurodevelopment assessed by Ages & Stages Questionnaire, 2nd edition (ASQ-II) was not associated to cord clamping time, placental transfusion or iron stores at 4 and 12 months [16, 17]
Demographic data between the study population and those who declined participation showed no significant differences in maternal age, gestational age, infants’ birth weight, length or head circumference, nor any differences in Apgar score or umbilical blood gases
Summary
With prelabour caesarean section rates growing globally, there is direct and indirect evidence of negative cognitive outcomes in childhood. Our research group has shown that waiting to clamp the umbilical cord for 30 s after prelabour CS resulted in higher iron stores at 4 months of age as compared to early cord clamping (CC) after vaginal birth [13]. The effect on iron stores was as pronounced as when clamping the umbilical cord after 180 s with vaginal delivery (delayed CC) [13] This would indicate that waiting for 30 s during prelabour caesarean birth to clamp the cord would suffice to ensure sufficient placental transfusion to ensure enhanced iron stores at 4 months. After additional growth and maturation, improved fine motor function and to some extent social behaviour was shown among children born after delayed CC ≥ 180 s [18]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
