Caesarean section and its relationship to offspring general cognitive ability: a registry-based cohort study of half a million young male adults.
Journal
Evidence-based mental health
ISSN: 1468-960X
Titre abrégé: Evid Based Ment Health
Pays: England
ID NLM: 100883413
Informations de publication
Date de publication:
02 2022
02 2022
Historique:
received:
20
07
2021
accepted:
28
08
2021
pubmed:
14
9
2021
medline:
16
2
2022
entrez:
13
9
2021
Statut:
ppublish
Résumé
A relationship between caesarean section and offspring cognitive ability has been described, but data are limited, and a large-scale study is needed. To determine the relationship between mode of delivery and general cognitive ability. A cohort of 579 244 singleton males, born between 1973 and 1987 who conscripted before 2006, were identified using the Swedish population-based registries. Their mode of delivery was obtained from the Swedish Medical Birth registry. The outcome measure was a normalised general cognitive test battery (mean 100, SD 15) performed at military conscription at around age 18. Males born by caesarean section performed poorer compared with those born vaginally (mean score 99.3 vs 100.1; adjusted mean difference -0.84; 95% CI -0.97 to -0.72; p<0.001). Both those born by elective (99.3 vs 100.2; -0.92; 95% CI -1.24 to -0.60; p<0.001) and non-elective caesarean section (99.2 vs 100.2; -1.03; 95% CI -1.34 to -0.72; p=0.001), performed poorer than those born vaginally. In sibling analyses, the association was attenuated to the null (100.9 vs 100.8; 0.07; 95% CI -0.31 to 0.45; p=0.712). Similarly, neither elective nor non-elective caesarean section were associated with general cognitive ability in sibling analyses. Birth by caesarean section is weakly associated with a lower general cognitive ability in young adult males. However, the magnitude of this association is not clinically relevant and seems to be largely explained by familial factors shared between siblings. Clinicians and gravidas ought not to be concerned that the choice of mode of delivery will impact offspring cognitive ability.
Sections du résumé
BACKGROUND
A relationship between caesarean section and offspring cognitive ability has been described, but data are limited, and a large-scale study is needed.
OBJECTIVE
To determine the relationship between mode of delivery and general cognitive ability.
METHODS
A cohort of 579 244 singleton males, born between 1973 and 1987 who conscripted before 2006, were identified using the Swedish population-based registries. Their mode of delivery was obtained from the Swedish Medical Birth registry. The outcome measure was a normalised general cognitive test battery (mean 100, SD 15) performed at military conscription at around age 18.
FINDINGS
Males born by caesarean section performed poorer compared with those born vaginally (mean score 99.3 vs 100.1; adjusted mean difference -0.84; 95% CI -0.97 to -0.72; p<0.001). Both those born by elective (99.3 vs 100.2; -0.92; 95% CI -1.24 to -0.60; p<0.001) and non-elective caesarean section (99.2 vs 100.2; -1.03; 95% CI -1.34 to -0.72; p=0.001), performed poorer than those born vaginally. In sibling analyses, the association was attenuated to the null (100.9 vs 100.8; 0.07; 95% CI -0.31 to 0.45; p=0.712). Similarly, neither elective nor non-elective caesarean section were associated with general cognitive ability in sibling analyses.
CONCLUSION
Birth by caesarean section is weakly associated with a lower general cognitive ability in young adult males. However, the magnitude of this association is not clinically relevant and seems to be largely explained by familial factors shared between siblings.
CLINICAL IMPLICATION
Clinicians and gravidas ought not to be concerned that the choice of mode of delivery will impact offspring cognitive ability.
Identifiants
pubmed: 34511405
pii: ebmental-2021-300307
doi: 10.1136/ebmental-2021-300307
pmc: PMC8788259
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
7-14Informations de copyright
© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY. Published by BMJ.
Déclaration de conflit d'intérêts
Competing interests: None declared.
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