PDF(Pubmed)
Abstract：
The long-term effects of a Cesarean section (CS) birth on child neurodevelopment are of increasing interest. In this study, we examined the associations between mode of delivery and presence of neurodevelopmental disorders in toddlers. Moreover, given that the prevalence of several neurodevelopmental disorders such as autism spectrum disorder (ASD) is known to differ by sex, we also investigated these associations separately in male and female toddlers.
We investigated 65,701 mother-toddler pairs from the Japan Environment and Children\'s Study, a nationally representative children\'s cohort study. To investigate the associations between mode of delivery (CS or vaginal delivery) and neurodevelopmental disorders (motor delay, intellectual disability, and ASD) in 3-year-old toddlers as a whole and stratified by sex, we used logistic regression models to calculate adjusted odds ratios (aORs) with 95% confidence intervals (CIs).
The morbidity of ASD at age 3 years was higher for children delivered by CS than those delivered vaginally (aOR 1.38, 95% CI 1.04-1.83). However, no such difference was evident in the case of motor delay or intellectual disability (aOR 1.33, 95% CI 0.94-1.89; aOR 1.18, 95% CI 0.94-1.49, respectively). In the analysis by sex, CS was not associated with increased risk of any of the neurodevelopmental disorders in males, but it was associated with increased risks of motor delay (aOR 1.88, 95% CI 1.02-3.47) and ASD (aOR 1.82, 95% CI 1.04-3.16) in females.
This study provides evidence of significant associations between mode of delivery and neurodevelopmental disorders in early childhood. Females may be more sensitive to the effects of CS than males.
We investigated 65,701 mother-toddler pairs from the Japan Environment and Children\'s Study, a nationally representative children\'s cohort study. To investigate the associations between mode of delivery (CS or vaginal delivery) and neurodevelopmental disorders (motor delay, intellectual disability, and ASD) in 3-year-old toddlers as a whole and stratified by sex, we used logistic regression models to calculate adjusted odds ratios (aORs) with 95% confidence intervals (CIs).
The morbidity of ASD at age 3 years was higher for children delivered by CS than those delivered vaginally (aOR 1.38, 95% CI 1.04-1.83). However, no such difference was evident in the case of motor delay or intellectual disability (aOR 1.33, 95% CI 0.94-1.89; aOR 1.18, 95% CI 0.94-1.49, respectively). In the analysis by sex, CS was not associated with increased risk of any of the neurodevelopmental disorders in males, but it was associated with increased risks of motor delay (aOR 1.88, 95% CI 1.02-3.47) and ASD (aOR 1.82, 95% CI 1.04-3.16) in females.
This study provides evidence of significant associations between mode of delivery and neurodevelopmental disorders in early childhood. Females may be more sensitive to the effects of CS than males.
摘要：
背景：剖宫产（CS）分娩对儿童神经发育的长期影响越来越受到关注。在这项研究中,我们研究了幼儿分娩方式与神经发育障碍之间的关联.此外，鉴于已知自闭症谱系障碍（ASD）等几种神经发育障碍的患病率因性别而异，我们还分别调查了男性和女性幼儿的这些关联。
方法：我们调查了来自日本环境与儿童研究的65,701对母婴对，具有全国代表性的儿童队列研究。调查分娩方式（CS或阴道分娩）与神经发育障碍（运动延迟，智力残疾,和ASD）在3岁的幼儿中作为一个整体，并按性别分层，我们使用逻辑回归模型以95%置信区间(CIs)计算校正比值比(aORs).
结果：经CS分娩的儿童在3岁时ASD的发病率高于经阴道分娩的儿童(aOR1.38,95%CI1.04-1.83)。然而,在运动延迟或智力残疾的情况下，没有明显的差异（分别为aOR1.33，95％CI0.94-1.89；aOR1.18，95％CI0.94-1.49）。在性别分析中，CS与男性任何神经发育障碍的风险增加无关，但与女性运动延迟(aOR1.88,95%CI1.02-3.47)和ASD(aOR1.82,95%CI1.04-3.16)风险增加相关.
结论：这项研究提供了分娩方式与儿童早期神经发育障碍之间显著关联的证据。女性对CS的影响可能比男性更敏感。
方法：我们调查了来自日本环境与儿童研究的65,701对母婴对，具有全国代表性的儿童队列研究。调查分娩方式（CS或阴道分娩）与神经发育障碍（运动延迟，智力残疾,和ASD）在3岁的幼儿中作为一个整体，并按性别分层，我们使用逻辑回归模型以95%置信区间(CIs)计算校正比值比(aORs).
结果：经CS分娩的儿童在3岁时ASD的发病率高于经阴道分娩的儿童(aOR1.38,95%CI1.04-1.83)。然而,在运动延迟或智力残疾的情况下，没有明显的差异（分别为aOR1.33，95％CI0.94-1.89；aOR1.18，95％CI0.94-1.49）。在性别分析中，CS与男性任何神经发育障碍的风险增加无关，但与女性运动延迟(aOR1.88,95%CI1.02-3.47)和ASD(aOR1.82,95%CI1.04-3.16)风险增加相关.
结论：这项研究提供了分娩方式与儿童早期神经发育障碍之间显著关联的证据。女性对CS的影响可能比男性更敏感。
