Childhood Health and Developmental Outcomes After Cesarean Birth in an Australian Cohort.

Abstract

Concerns have been raised about associations between cesarean delivery and childhood obesity and asthma. However, published studies have not examined the long-term neurodevelopmental outcomes or fully addressed confounding influences. We used data from the LSAC (Longitudinal Study of Australian Children) to explore the relationship between cesarean delivery and physical and socio-emotional outcomes from 0 to 7 years, taking into account confounding factors. Data were from 5 waves of LSAC representing 5107 children born in 2003 and 2004. Outcome measures included: global health, asthma, BMI, use of prescribed medication, general development, medical conditions and/or disabilities, special health care needs, and socio-emotional development. Models adjusted for birth factors, social vulnerability, maternal BMI, and breastfeeding. Children born by cesarean delivery were more likely to have a medical condition at 2 to 3 years (odds ratio: 1.33; P = .03), use prescribed medication at 6 to 7 years (odds ratio: 1.26; P = .04), and have a higher BMI at 8 to 9 years (coefficient: 0.08; P = .05), although this last effect was mediated by maternal obesity. Parent-reported quality of life for children born by cesarean delivery was lower at 8 to 9 years (coefficient: -0.08; P = .03) but not at younger ages. Contrasting this finding, cesarean delivery was associated with better parent-reported global health at 2 to 3 years (odds ratio: 1.23; P = .05) and prosocial skills at age 6 to 7 years (coefficient: 0.09; P = .02). Cesarean delivery was associated with a mix of positive and negative outcomes across early childhood, but overall there were few associations, and these were not consistent across the 5 waves. This study does not support a strong association between cesarean delivery and poorer health or neurodevelopmental outcomes in childhood.