The association of birth by caesarean section and cognitive outcomes in offspring: a systematic review.
Birth
Child development
Intelligence
Neurodevelopment
Obstetric complications
Youth
Journal
Social psychiatry and psychiatric epidemiology
ISSN: 1433-9285
Titre abrégé: Soc Psychiatry Psychiatr Epidemiol
Pays: Germany
ID NLM: 8804358
Informations de publication
Date de publication:
Apr 2021
Apr 2021
Historique:
received:
09
05
2020
accepted:
07
12
2020
pubmed:
4
1
2021
medline:
21
4
2021
entrez:
3
1
2021
Statut:
ppublish
Résumé
Studies have reported children born by caesarean section are more likely to have lower cognitive outcomes compared to those born by vaginal delivery. This paper reviews the literature examining caesarean birth and offspring cognitive outcomes. A systematic search for observational studies or case-control studies that compared cognitive outcomes of people born by caesarean section with those born by vaginal delivery was conducted in six databases (Medline, PubMed, EMBASE, PsychInfo, CINAHL, Web of Science) from inception until December 2019 according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Studies were assessed for quality and a narrative synthesis was undertaken considering the evidence for a causal relationship according to the Bradford Hill Criteria. A total of seven studies were identified. Of these, four found a significant association between elective and emergency caesarean birth and reduction in offspring cognitive performance as measured by school performance or validated cognitive testing. Three studies found no association. There was variability in the quality of the studies, assessment of the reason for caesarean section (emergency vs elective), measurement of outcomes and adjustment for confounding factors. The evidence of an association between CS birth and lower offspring cognitive functioning is inconsistent. Based on currently available data, there is no evidence that a causal association exists. To better examine this association, future studies should (a) distinguish elective and emergency caesareans, (b) adequately adjust for confounding variables and (c) have valid outcome measures of cognition.
Identifiants
pubmed: 33388795
doi: 10.1007/s00127-020-02008-2
pii: 10.1007/s00127-020-02008-2
doi:
Types de publication
Journal Article
Review
Systematic Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
533-545Références
Boerma T, Ronsmans C, Melesse D, Barros A, Barros F, Juan L, Moller AB, Say L, Hosseinpoor A, Yi M, Neto DD, Temmerman M (2018) Global epidemiology of use of and disparities in caesarean sections. Lancet (London, England) 392(10155):1341–1348. https://doi.org/10.1016/S0140-6736(18)31928-7
doi: 10.1016/S0140-6736(18)31928-7
OECD (2018) Caesarean sections. https://data.oecd.org/healthcare/caesarean-sections.htm . 2020
Sandall J, Tribe RM, Avery L, Mola G, Visser GH, Homer CS, Gibbons D, Kelly NM, Kennedy HP, Kidanto H, Taylor P, Temmerman M (2018) Short-term and long-term effects of caesarean section on the health of women and children. Lancet 392(10155):1349–1357. https://doi.org/10.1016/S0140-6736(18)31930-5
doi: 10.1016/S0140-6736(18)31930-5
pubmed: 30322585
Gibbons L, Belizán J, Lauer J, Betrán A, Merialdi M, Althabe F (2010) The global numbers and costs of additionally needed and unnecessary caesarean sections performed per year: overuse as a barrier to universal coverage health systems financing. World Health Report 30:1–31
Jakobsson HE, Abrahamsson T, Jenmalm MC, Harris K, Quince C, Jernberg C, Björkstén B, Engstrand L, Andersson AF (2014) Decreased gut microbiota diversity, delayed Bacteroidetes colonisation and reduced Th1 responses in infants delivered by Caesarean section. Gut 63(4):559–566. https://doi.org/10.1136/gutjnl-2012-303249
doi: 10.1136/gutjnl-2012-303249
pubmed: 23926244
Hansen AK, Wisborg K, Uldbjerg N, Henriksen TB (2008) Risk of respiratory morbidity in term infants delivered by elective caesarean section: cohort study (Clinical report). Br Med J 336(7635):85. https://doi.org/10.1136/bmj.39405.539282.be
doi: 10.1136/bmj.39405.539282.be
Rossi S, Matsui E (2017) Cesarean section delivery and development of food allergy and atopic dermatitis in early childhood. Pediatrics 140(6):S177
Keag OE, Norman JE, Stock SJ (2018) Long-term risks and benefits associated with cesarean delivery for mother, baby, and subsequent pregnancies: systematic review and meta-analysis (research article) (report). PLoS Med 15(1):e1002494. https://doi.org/10.1371/journal.pmed.1002494
doi: 10.1371/journal.pmed.1002494
pubmed: 29360829
pmcid: 5779640
Kristensen K, Henriksen L (2016) Cesarean section and disease associated with immune function. J Allergy Clin Immunol 137(2):587–590. https://doi.org/10.1016/j.jaci.2015.07.040
doi: 10.1016/j.jaci.2015.07.040
pubmed: 26371844
Peters LL, Thornton C, de Jonge A, Khashan A, Tracy M, Downe S, Feijen-de Jong EI, Dahlen HG (2018) The effect of medical and operative birth interventions on child health outcomes in the first 28 days and up to 5 years of age: a linked data population-based cohort study. Birth (Berkeley, Calif) 45(4):347–357. https://doi.org/10.1111/birt.12348
doi: 10.1111/birt.12348
McKeever TM, Lewis SA, Smith C, Hubbard R (2002) Mode of delivery and risk of developing allergic disease. J Allergy Clin Immunol 109(5):800–802. https://doi.org/10.1067/mai.2002.124046
doi: 10.1067/mai.2002.124046
pubmed: 11994703
Barros FC, Matijasevich A, Hallal PC, Horta BL, Barros AJ, Menezes AB, Santos IS, Gigante DP, Victora CG (2012) Cesarean section and risk of obesity in childhood, adolescence, and early adulthood: evidence from 3 Brazilian birth cohorts (Nutritional epidemiology and public health) (author abstract) (clinical report). Am J Clin Nutr 95(2):465. https://doi.org/10.3945/ajcn.111.026401
doi: 10.3945/ajcn.111.026401
pubmed: 22237058
pmcid: 3260073
Curran EA, Cryan JF, Kenny LC, Dinan TG, Kearney PM, Khashan AS (2016) Obstetrical mode of delivery and childhood behavior and psychological development in a British cohort. J Autism Dev Disord 46(2):603–614. https://doi.org/10.1007/s10803-015-2616-1
doi: 10.1007/s10803-015-2616-1
pubmed: 26412364
Calvin CM, Deary IJ, Fenton C, Roberts BA, Der G, Leckenby N, Batty GD (2011) Intelligence in youth and all-cause-mortality: systematic review with meta-analysis. Int J Epidemiol 40(3):626–644. https://doi.org/10.1093/ije/dyq190
doi: 10.1093/ije/dyq190
pubmed: 21037248
Romero R, Korzeniewski SJ (2013) Are infants born by elective cesarean delivery without labor at risk for developing immune disorders later in life? Am J Obstet Gynecol 208(4):243–246. https://doi.org/10.1016/j.ajog.2012.12.026
doi: 10.1016/j.ajog.2012.12.026
pubmed: 23273890
Cong X, Henderson WA, Graf J, McGrath JM (2015) Early life experience and gut microbiome: the brain–gut–microbiota signaling system. Adv Neonatal Care 15(5):E1–E2. https://doi.org/10.1097/ANC.0000000000000191
doi: 10.1097/ANC.0000000000000191
Polidano C, Zhu A, Bornstein JC (2017) The relation between cesarean birth and child cognitive development. Sci Rep 7(1):11483. https://doi.org/10.1038/s41598-017-10831-y
doi: 10.1038/s41598-017-10831-y
pubmed: 28904336
pmcid: 5597642
Al Khalaf SY, O’Neill SM, O’Keeffe LM, Henriksen TB, Kenny LC, Cryan JF, Khashan AS (2015) The impact of obstetric mode of delivery on childhood behavior. Soc Psychiatry Psychiatr Epidemiol 50(10):1557–1567. https://doi.org/10.1007/s00127-015-1055-9
doi: 10.1007/s00127-015-1055-9
pubmed: 25868660
Khadem N, Khadivzadeh T (2010) The intelligence quotient of school aged children delivered by cesarean section and vaginal delivery. Iran J Nurs Midwifery Res 15(3):135–140
pubmed: 21589777
pmcid: 3093169
Hanrahan M, McCarthy FP, O’Keeffe GW, Khashan AS (2019) The association between caesarean section and cognitive ability in childhood. Soc Psychiatry Psychiatr Epidemiol. https://doi.org/10.1007/s00127-019-01798-4
doi: 10.1007/s00127-019-01798-4
pubmed: 31641827
Curran EA, Kenny LC, Dalman C, Kearney PM, Cryan JF, Dinan TG, Khashan AS (2017) Birth by caesarean section and school performance in Swedish adolescents- a population-based study. BMC Pregnancy Childbirth 17(1):121. https://doi.org/10.1186/s12884-017-1304-x
doi: 10.1186/s12884-017-1304-x
pubmed: 28415966
pmcid: 5392943
Moher D, Liberati A, Tetzlaff J, Altman DG (2009) Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. J Clin Epidemiol 62(10):1006–1012. https://doi.org/10.1016/j.jclinepi.2009.06.005
doi: 10.1016/j.jclinepi.2009.06.005
pubmed: 19631508
Canivez GL, Watkins MW (1998) Long-term stability of the wechsler intelligence scale for children—third edition. Psychol Assess 10(3):285–291. https://doi.org/10.1037/1040-3590.10.3.285
doi: 10.1037/1040-3590.10.3.285
Halbwachs M, Muller J-B, Nguyen The Tich S, de La Rochebrochard E, Gascoin G, Branger B, Rouger V, Roze J-C, Flamant C (2013) Usefulness of parent-completed ASQ for neurodevelopmental screening of preterm children at five years of age (research article). PLoS ONE 8(8):e71925. https://doi.org/10.1371/journal.pone.0071925
doi: 10.1371/journal.pone.0071925
pubmed: 24014166
pmcid: 3754941
Wells G, Shea B, O’Connell D, Peterson j, Welch V, Losos M, Tugwell P (2000) The Newcastle–Ottawa Scale (NOS) for assessing the quality of non-randomized studies in meta-analysis
Adhikari K, McNeil DA, McDonald S, Patel AB, Metcalfe A (2018) Differences in caesarean rates across women’s socio-economic status by diverse obstetric indications: cross-sectional study. Paediatr Perinat Epidemiol 32(4):309–317. https://doi.org/10.1111/ppe.12484
doi: 10.1111/ppe.12484
pubmed: 29975426
Jenabi E, Khazaei S, Bashirian S, Aghababaei S, Matinnia N (2019) Reasons for elective cesarean section on maternal request: a systematic review. J Maternal Fetal Neonat Med 33:3867–3872. https://doi.org/10.1080/14767058.2019.1587407
doi: 10.1080/14767058.2019.1587407
Smithers LG, Mol BW, Wilkinson C, Lynch JW (2016) Implications of caesarean section for children’s school achievement: a population-based study. Aust N Z J Obstetr Gynaecol 56(4):374–380. https://doi.org/10.1111/ajo.12475
doi: 10.1111/ajo.12475
Li H-T, Ye R-W, Pei L-J, Ren A-G, Zheng X-Y, Liu J-M (2011) Cesarean delivery on maternal request and childhood intelligence: a cohort study. Chin Med J 124(23):3982–3987. https://doi.org/10.3760/cma.j.issn.0366-6999.2011.23.025
doi: 10.3760/cma.j.issn.0366-6999.2011.23.025
pubmed: 22340328
World Health Organization (2016) Births by caesarean section. World Health Organization, Geneva
Norgaard M, Ehrenstein V, Vandenbroucke JP (2017) Confounding in observational studies based on large health care databases: problems and potential solutions—a primer for the clinician (methodology) (report). Clin Epidemiol 9:185. https://doi.org/10.2147/clep.s129879
doi: 10.2147/clep.s129879
pubmed: 28405173
pmcid: 5378455
D’Onofrio BM, Rickert ME, Frans E, Kuja-Halkola R, Almqvist C, Sjölander A, Larsson H, Lichtenstein P (2014) Paternal age at childbearing and offspring psychiatric and academic morbidity. JAMA Psychiatry 71(4):432–438. https://doi.org/10.1001/jamapsychiatry.2013.4525
doi: 10.1001/jamapsychiatry.2013.4525
pubmed: 24577047
pmcid: 3976758
Eide MG, Øyen N, Skjærven R, Irgens LM, Bjerkedal T, Nilsen ST (2005) Breech delivery and intelligence: a population-based study of 8,738 breech infants. Obstetr Gynecol 105(1):4–11. https://doi.org/10.1097/01.aog.0000149743.80837.d3
doi: 10.1097/01.aog.0000149743.80837.d3
Mackay DF, Wood R, King A, Clark DN, Cooper SA, Smith GC, Pell JP (2015) Educational outcomes following breech delivery: a record-linkage study of 456 947 children. Int J Epidemiol 44(1):209–217. https://doi.org/10.1093/ije/dyu270
doi: 10.1093/ije/dyu270
pubmed: 25613426
pmcid: 4415090
Sorensen HT, Steffensen FH, Olsen J, Sabroe S, Gillman MW, Fischer P, Rothman KJ (1999) Long-term follow-up of cognitive outcome after breech presentation at birth. Epidemiology 10(5):554–556. https://doi.org/10.1097/00001648-199909000-00016
doi: 10.1097/00001648-199909000-00016
pubmed: 10468431
Coletti MF, Caravale B, Gasparini C, Franco F, Campi F, Dotta A (2015) One-year neurodevelopmental outcome of very and late preterm infants: risk factors and correlation with maternal stress. Infant Behav Dev 39:11–20. https://doi.org/10.1016/j.infbeh.2015.01.003
doi: 10.1016/j.infbeh.2015.01.003
pubmed: 25779697
Kimura T, Takeuchi M, Imai T, Tanaka S, Kawakami K (2017) Neurodevelopment at 3 years in neonates born by vaginal delivery versus cesarean section at < 26 weeks of gestation: retrospective analysis of a nationwide registry in Japan. Neonatology 112(3):258–266. https://doi.org/10.1159/000477293
doi: 10.1159/000477293
pubmed: 28715797
Litt R, Armon Y, Seidman DS, Yafe H, Gale R (1993) The effect of mode of delivery on long-term outcome of very low birthweight infants. Eur J Obstet Gynecol Reprod Biol 52(1):5–10. https://doi.org/10.1016/0028-2243(93)90218-2
doi: 10.1016/0028-2243(93)90218-2
pubmed: 8119476
Običan SG, Small A, Smith D, Levin H, Drassinower D, Gyamfi-Bannerman C (2015) Mode of delivery at periviability and early childhood neurodevelopment. Am J Obstetr Gynecol 213(4):578.e571–578.e574. https://doi.org/10.1016/j.ajog.2015.06.047
doi: 10.1016/j.ajog.2015.06.047
Zhu JJ, Bao YY, Zhang GL, Ma LX, Wu MY (2014) No relationship between mode of delivery and neonatal mortality and neurodevelopment in very low birth weight infants aged two years. World J Pediatr WJP 10(3):227–231. https://doi.org/10.1007/s12519-014-0497-6
doi: 10.1007/s12519-014-0497-6
pubmed: 25124973
Lucas RM, McMichael A (2005) Association or causation: evaluating links between “environment and disease”. Bull World Health Organ 83(10):792–795
pubmed: 16283057
pmcid: 2626424
Diamond B, Huerta PT, Tracey K, Volpe BT (2011) It takes guts to grow a brain: increasing evidence of the important role of the intestinal microflora in neuro- and immune-modulatory functions during development and adulthood. BioEssays: News Rev Mol Cell Dev Biol 33(8):588–591. https://doi.org/10.1002/bies.201100042
doi: 10.1002/bies.201100042
Gareau MG, Wine E, Rodrigues DM, Cho JH, Whary MT, Philpott DJ, MacQueen G, Sherman PM (2011) Bacterial infection causes stress-induced memory dysfunction in mice. Gut 60(3):307. https://doi.org/10.1136/gut.2009.202515
doi: 10.1136/gut.2009.202515
pubmed: 20966022
Jane AF, Linda R, John FC (2017) Stress and the gut-brain axis: regulation by the microbiome. Neurobiol Stress 7:124–136
doi: 10.1016/j.ynstr.2017.03.001
Neu J, Rushing J (2011) Cesarean versus vaginal delivery: long-term infant outcomes and the hygiene hypothesis. Clin Perinatol 38(2):321–331. https://doi.org/10.1016/j.clp.2011.03.008
doi: 10.1016/j.clp.2011.03.008
pubmed: 21645799
pmcid: 3110651
Peters LL, Thornton C, De Jonge A, Khashan A, Tracy M, Downe S, Feijen-De Jong EI, Dahlen HG (2018) The effect of medical and operative birth interventions on child health outcomes in the first 28 days and up to 5 years of age: a linked data population-based cohort study. Birth 45(4):347–357. https://doi.org/10.1111/birt.12348
doi: 10.1111/birt.12348
pubmed: 29577380
pmcid: 6282837
Miller NM, Fisk NM, Modi N, Glover V (2005) Stress responses at birth: determinants of cord arterial cortisol and links with cortisol response in infancy. BJOG Int J Obstetr Gynaecol 112(7):921–926. https://doi.org/10.1111/j.1471-0528.2005.00620.x
doi: 10.1111/j.1471-0528.2005.00620.x
Hyde MJ, Mostyn A, Modi N, Kemp PR (2012) The health implications of birth by Caesarean section. Biol Rev 87(1):229–243. https://doi.org/10.1111/j.1469-185x.2011.00195.x
doi: 10.1111/j.1469-185x.2011.00195.x
pubmed: 21815988
Curran EA, Khashan AS, Dalman C, Kenny LC, Cryan JF, Dinan TG, Kearney PM (2016) Obstetric mode of delivery and attention-deficit/hyperactivity disorder: a sibling-matched study. Int J Epidemiol 45(2):532–542. https://doi.org/10.1093/ije/dyw001
doi: 10.1093/ije/dyw001
pubmed: 27063604
Lawlor DA, Najman JM, Batty GD, O’Callaghan MJ, Williams GM, Bor W (2006) Early life predictors of childhood intelligence: findings from the Mater-University study of pregnancy and its outcomes. Paediatr Perinat Epidemiol 20(2):148–162. https://doi.org/10.1111/j.1365-3016.2006.00704.x
doi: 10.1111/j.1365-3016.2006.00704.x
pubmed: 16466433
Betrán AP, Temmerman M, Kingdon C, Mohiddin A, Opiyo N, Torloni MR, Zhang J, Musana O, Wanyonyi SZ, Gülmezoglu AM, Downe S (2018) Interventions to reduce unnecessary caesarean sections in healthy women and babies. Lancet 392(10155):1358–1368. https://doi.org/10.1016/S0140-6736(18)31927-5
doi: 10.1016/S0140-6736(18)31927-5
pubmed: 30322586