title: Childhood Health and Developmental Outcomes After Cesarean Birth in an Australian Cohort.
abstract: OBJECTIVE
  Concerns have been raised about associations between cesarean delivery and childhood obesity and asthma. However, published studies have not examined the long-term neurodevelopmental outcomes or fully addressed confounding influences. We used data from the LSAC (Longitudinal Study of Australian Children) to explore the relationship between cesarean delivery and physical and socio-emotional outcomes from 0 to 7 years, taking into account confounding factors.
  
  
  METHODS
  Data were from 5 waves of LSAC representing 5107 children born in 2003 and 2004. Outcome measures included: global health, asthma, BMI, use of prescribed medication, general development, medical conditions and/or disabilities, special health care needs, and socio-emotional development. Models adjusted for birth factors, social vulnerability, maternal BMI, and breastfeeding.
  
  
  RESULTS
  Children born by cesarean delivery were more likely to have a medical condition at 2 to 3 years (odds ratio: 1.33; P = .03), use prescribed medication at 6 to 7 years (odds ratio: 1.26; P = .04), and have a higher BMI at 8 to 9 years (coefficient: 0.08; P = .05), although this last effect was mediated by maternal obesity. Parent-reported quality of life for children born by cesarean delivery was lower at 8 to 9 years (coefficient: -0.08; P = .03) but not at younger ages. Contrasting this finding, cesarean delivery was associated with better parent-reported global health at 2 to 3 years (odds ratio: 1.23; P = .05) and prosocial skills at age 6 to 7 years (coefficient: 0.09; P = .02).
  
  
  CONCLUSIONS
  Cesarean delivery was associated with a mix of positive and negative outcomes across early childhood, but overall there were few associations, and these were not consistent across the 5 waves. This study does not support a strong association between cesarean delivery and poorer health or neurodevelopmental outcomes in childhood.
authors.affiliation: Department of Obstetrics and Gynaecology, and stephen.robson@anu.edu.au.
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Robson
authors.affiliation: School of Psychology and Public Health, and.
authors.forename: Hassan
authors.initials: H
authors.lastname: Vally
authors.affiliation: Department of Neonatology, Centenary Hospital for Women and Children, Canberra Hospital, Canberra, Australia; Discipline of Neonatology, Medical School, College of Medicine, Biology and Environment, Australian National University, Canberra, Australia;
authors.forename: Mohamed E
authors.initials: ME
authors.lastname: Abdel-Latif
authors.affiliation: Parenting Research Centre, Melbourne, Australia;
authors.forename: Maggie
authors.initials: M
authors.lastname: Yu
authors.affiliation: Parenting Research Centre, Melbourne, Australia; Judith Lumley Centre, La Trobe University, Melbourne, Australia; School of Population Health, Murdoch Children's Research Institute, Melbourne, Australia.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Westrupp
mesh_terms: D001315:Australia / Q000453:epidemiology; D015992:Body Mass Index; D002585:Cesarean Section; D002648:Child; D002657:Child Development; D002675:Child, Preschool; D015986:Confounding Factors, Epidemiologic; D002658:Developmental Disabilities / Q000453:epidemiology; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D011788:Quality of Life