12/16/2023 0 Comments Asq manuscript centralThe aim of this study was to investigate the association between prelabour CS and neurodevelopmental outcomes in infants at 4 and 12 months of age. After additional growth and maturation, improved fine motor function and to some extent social behaviour was shown among children born after delayed CC ≥ 180 s. In research on delayed cord clamping in vaginal births, improved brain myelin content is present at 4 and 12 months, but neurodevelopment assessed by Ages & Stages Questionnaire, 2nd edition (ASQ-II) was not associated to cord clamping time, placental transfusion or iron stores at 4 and 12 months. This would indicate that waiting for 30 s during prelabour caesarean birth to clamp the cord would suffice to ensure sufficient placental transfusion to ensure enhanced iron stores at 4 months. In fact, the effect on iron stores was as pronounced as when clamping the umbilical cord after 180 s with vaginal delivery (delayed CC). Our research group has shown that waiting to clamp the umbilical cord for 30 s after prelabour CS resulted in higher iron stores at 4 months of age as compared to early cord clamping (CC) after vaginal birth. A large population-based study in Sweden found that children delivered by CS were at higher risk to be treated in hospital, all diagnoses considered, in their pre-school years as compared to non-instrumental vaginally delivered children. Furthermore, caesarean sections have been associated with altered mother-child interactions and lower rates of breastfeeding. Recent studies have shown that prelabour CS may be associated with adverse child cognitive score outcome and school performance. Caesarean births have been associated with asthma, type 1 diabetes, allergies, obesity and have been linked to impaired functioning and lower academic performance. The rising rate of caesarean births across the world has been directly and indirectly associated with negative child cognitive outcomes. On the other end of the spectrum, countries like Chile, Mexico and Turkey have rates ranging from 45 to 53%. Sweden has one of the lowest caesarean section (CS) rates in the world (17%). Additional studies are warranted to explore this relationship further.Ĭaesarean sections are effective and lifesaving procedures but the World Health Organization (WHO) regards rates higher than 10% as not associated with reductions in maternal and newborn mortality rates. ConclusionsĪdverse neurodevelopmental outcomes in infants born by prelabour caesarean section may be apparent already a few months after birth. These differences remained for gross-motor skills at the 12 month assessment, adjusted mean difference (95% CI) -4.7 (− 8.8 to − 0.7), n = 62 and 336. Prelabour caesarean infants ( n = 66) had significantly lower Ages and Stages Questionnaire, second edition (ASQ-II) scores in all domains (communication, gross motor, fine motor, problem solving and personal-social) at 4 months of age with an adjusted mean difference (95% CI) of − 20.7 (− 28.7 to − 12.6) in ASQ-II total score as compared to vaginally born infants ( n = 352). Follow-up assessments were performed at 4 and 12 months. Infants born by prelabour caesarean section were compared with a group of vaginally born infants. We conducted a prospective, observational study of infants delivered by prelabour caesarean section at the Hospital of Halland, Halmstad, Sweden and compared their development with an historical group of infants born by non-instrumental vaginal delivery. The objective of this study was to assess the short-term neurodevelopmental outcomes after prelabour caesarean section as compared to vaginally born infants. With prelabour caesarean section rates growing globally, there is direct and indirect evidence of negative cognitive outcomes in childhood.
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