The impact of obstetric mode of delivery on childhood behavior
The impact of obstetric mode of delivery on childhood behavior
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DOI：
10.1007/s00127-015-1055-9
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发表时间：
2015-10-01
影响因子：
4.4
通讯作者：
Khashan, Ali S.
中科院分区：
文献类型：
--
作者：
Al Khalaf, Sukainah Y.;O'Neill, Sinead M.;Khashan, Ali S.
我们调查了分娩方式影响儿童行为和运动发育的假设，并检查了是否存在性别特异性关联，即男性和女性是否有不同的风险估计。随机选择并招募 2007 年 12 月至 2008 年 5 月期间出生婴儿的家庭 (N = 11,134) 并招募到爱尔兰成长研究中。分娩方式分为阴道自然分娩；阴道助产器助产；紧急剖腹产（CS）；和选修计算机科学。 “年龄和阶段问卷”在 9 个月大时完成，“优势和困难问卷”在 3 岁时完成。对数据进行加权以代表全国样本 (N = 73,662)，并使用多变量逻辑回归进行统计分析。 9 个月大时，选择性 CS 与个人社交技能的延迟相关 [调整后的比值比，aOR 1.24； (95% 置信区间，CI 1.04, 1.48)] 和粗大运动功能 [aOR 1.62，(95% CI 1.34，1.96)]，而紧急 CS 与粗大运动功能延迟相关 [aOR 1.30，(95% CI 1.06，1.59)]。 3 岁时，所有分娩方式的 SDQ 总分异常风险均未显着增加。通过选择性 CS 出生的儿童在 9 个月大时可能会面临认知和运动发育延迟。所有交付方式的 SDQ 总分均未增加。需要进一步研究以在其他人群中复制这些发现并探索潜在的生物学机制。
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.