Michael Hanrahan1, Fergus P McCarthy2,3, Gerard W O'Keeffe4, Ali S Khashan5,6. 1. School of Public Health, Western Gateway Building, University College Cork, Cork, Ireland. 2. The Irish Centre for Fetal and Neonatal Translational Research (INFANT), University College Cork, Cork, Ireland. 3. Department of Obstetrics and Gynaecology, University College Cork, Cork, Ireland. 4. Department of Anatomy and Neuroscience, University College Cork, Cork, Ireland. 5. School of Public Health, Western Gateway Building, University College Cork, Cork, Ireland. a.khashan@ucc.ie. 6. The Irish Centre for Fetal and Neonatal Translational Research (INFANT), University College Cork, Cork, Ireland. a.khashan@ucc.ie.
Abstract
PURPOSE: Global rates of caesarean section (CS) rates have increased rapidly in recent years. This is a growing public health concern as it has been proposed that CS may impact cognitive outcomes in childhood. However, the evidence for this association is limited and inconsistent. Therefore, the aim of this study was to investigate the relationship between obstetric mode of delivery and longitudinal cognitive outcomes in childhood. METHODS: We examined this question using data from a longitudinal cohort study of 8845 participants from the Millennium Cohort Study, a nationally representative UK cohort, who completed a range of verbal and visual-spatial cognitive assessments at ages 3, 5, 7 and 11 years. RESULTS: We found a statistically significant association between planned CS and visual-spatial cognitive delay in the pattern construction assessment at age 5 (OR 1.31, 95% CI 0.99-1.72) and age 7 (OR 1.42, 95% CI 1.12-1.81). Additionally planned CS was also associated with increased odds of "early childhood delay" (OR 1.70, 95% CI 1.15-2.50) and borderline increased odds of "persistent delay" (OR 1.37, 95% CI 0.99-1.89) in visual-spatial cognitive tests. Mode of delivery was not associated with verbal ability or with patterns of delay at any age point in verbal cognitive tests. CONCLUSION: We have reported a small association between planned CS and visual-spatial cognitive delay in childhood. However, while this result should be interpreted with caution, it highlights the need to further explore this potential relationship and the causal basis of such an association.
PURPOSE: Global rates of caesarean section (CS) rates have increased rapidly in recent years. This is a growing public health concern as it has been proposed that CS may impact cognitive outcomes in childhood. However, the evidence for this association is limited and inconsistent. Therefore, the aim of this study was to investigate the relationship between obstetric mode of delivery and longitudinal cognitive outcomes in childhood. METHODS: We examined this question using data from a longitudinal cohort study of 8845 participants from the Millennium Cohort Study, a nationally representative UK cohort, who completed a range of verbal and visual-spatial cognitive assessments at ages 3, 5, 7 and 11 years. RESULTS: We found a statistically significant association between planned CS and visual-spatial cognitive delay in the pattern construction assessment at age 5 (OR 1.31, 95% CI 0.99-1.72) and age 7 (OR 1.42, 95% CI 1.12-1.81). Additionally planned CS was also associated with increased odds of "early childhood delay" (OR 1.70, 95% CI 1.15-2.50) and borderline increased odds of "persistent delay" (OR 1.37, 95% CI 0.99-1.89) in visual-spatial cognitive tests. Mode of delivery was not associated with verbal ability or with patterns of delay at any age point in verbal cognitive tests. CONCLUSION: We have reported a small association between planned CS and visual-spatial cognitive delay in childhood. However, while this result should be interpreted with caution, it highlights the need to further explore this potential relationship and the causal basis of such an association.
Entities:
Keywords:
Caesarean section; Cognitive ability; Obstetric mode of delivery
Authors: Anthea Lindquist; Roxanne Hastie; Amber Kennedy; Lyle Gurrin; Anna Middleton; Jon Quach; Jeanie Cheong; Susan P Walker; Richard Hiscock; Stephen Tong Journal: JAMA Pediatr Date: 2022-07-01 Impact factor: 26.796