title: The impact of obstetric mode of delivery on childhood behavior.
abstract: OBJECTIVE
  We investigated the hypothesis that mode of delivery affects childhood behavior and motor development and examined whether there are sex-specific associations, i.e., whether males and females have different risk estimates.
  
  
  METHODS
  Families with infants born between December 2007 and May 2008 (N = 11,134) were randomly selected and recruited to the Growing Up in Ireland study. Mode of delivery was classified into spontaneous vaginal delivery; instrumental vaginal delivery; emergency Cesarean section (CS); and elective CS. The 'Ages and Stages Questionnaire' was completed at age 9-months and the 'Strengths and Difficulties Questionnaire' at 3 years. Data were weighted to represent the national sample (N = 73,662) and multivariate logistic regression was used for the statistical analyses.
  
  
  RESULTS
  At age 9 months, elective CS was associated with a delay in personal social skills [adjusted odds ratio, aOR 1.24; (95% confidence interval, CI 1.04, 1.48)] and gross motor function [aOR 1.62, (95% CI 1.34, 1.96)], whereas emergency CS was associated with delayed gross motor function [aOR 1.30, (95% CI 1.06, 1.59)]. At age 3 years there was no significantly increased risk of an abnormal total SDQ score across all modes of delivery.
  
  
  CONCLUSIONS
  Children born by elective CS may face a delay in cognitive and motor development at age 9 months. No increase in total SDQ score was found across all modes of delivery. Further investigation is needed to replicate these findings in other populations and explore the potential biological mechanisms.
authors: Department of Epidemiology and Public Health, University College Cork, Fourth Floor, Western Gate Building, Cork, Ireland.
authors: Sukainah Y
authors: SY
authors: Al Khalaf
authors: Department of Obstetrics and Gynaecology, National Perinatal Epidemiology Centre (NPEC), Cork University Maternity Hospital, Wilton, Cork, Ireland.|Department of Obstetrics and Gynaecology, The Irish Centre for Fetal and Neonatal Translational Research (INFANT), University College Cork, Cork, Ireland.
authors: Sinéad M
authors: SM
authors: O'Neill
authors: Department of Epidemiology and Public Health, University College Cork, Fourth Floor, Western Gate Building, Cork, Ireland. l.okeeffe@ucc.ie.|Department of Obstetrics and Gynaecology, National Perinatal Epidemiology Centre (NPEC), Cork University Maternity Hospital, Wilton, Cork, Ireland. l.okeeffe@ucc.ie.
authors: Linda M
authors: LM
authors: O'Keeffe
authors: Perinatal Epidemiology Research Unit, Department of Pediatrics, Aarhus University Hospital, Skejby, Denmark.
authors: Tine B
authors: TB
authors: Henriksen
authors: Department of Obstetrics and Gynaecology, The Irish Centre for Fetal and Neonatal Translational Research (INFANT), University College Cork, Cork, Ireland.
authors: Louise C
authors: LC
authors: Kenny
authors: Department of Anatomy and Neuroscience, Alimentary Pharmabiotic Centre, University College Cork, Cork, Ireland.
authors: John F
authors: JF
authors: Cryan
authors: Department of Epidemiology and Public Health, University College Cork, Fourth Floor, Western Gate Building, Cork, Ireland. a.khashan@ucc.ie.|Department of Obstetrics and Gynaecology, The Irish Centre for Fetal and Neonatal Translational Research (INFANT), University College Cork, Cork, Ireland. a.khashan@ucc.ie.
authors: Ali S
authors: AS
authors: Khashan
mesh_terms: D000293:Adolescent; D000328:Adult; D002585:Cesarean Section / Q000706:statistics & numerical data; D002652:Child Behavior / Q000523:psychology*; D002675:Child, Preschool; D036861:Delivery, Obstetric / Q000379:methods* / Q000706:statistics & numerical data; D017558:Elective Surgical Procedures / Q000706:statistics & numerical data; D004632:Emergency Medical Services / Q000706:statistics & numerical data; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007494:Ireland; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D011247:Pregnancy; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Behavioral development; Cesarean section; Childhood behavioral problems; Cognitive skills; Obstetric mode of delivery