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14-11-2010 | Gynaecology | Article

Elective cesarean reduces psychopathological problems in childhood


Journal abstract

MedWire News: Babies born by cesarean delivery on maternal request (CDMR) are less likely to develop psychopathological problems in childhood than babies born by spontaneous vaginal delivery (SVD), study findings show.

Furthermore, assisted vaginal delivery (AVD) carried the greatest probability of psychopathological problems in childhood compared with CDMR and SVD.

"Our findings suggested that CDMR probably benefited later childhood emotional and behavioral development, although more comprehensive assessments including the impact of CDMR on children's cognitive and physical development are needed before making any medical recommendations," say Jianmen Liu (Peking University Health Science Center, Beijing, China) and colleagues.

Using the Child Behavior Checklist (CBCL), the researchers evaluated emotional (internalizing) and behavioral (externalizing) problems among 4,190 preschool children: 100 delivered by CDMR; 3,563 delivered by SVD; and 527 delivered by AVD (forceps and vacuum extraction).

Mean CBCL scores for CDMR, SVD, and AVD births differed significantly, at 20.9, 23.0, and 25.0, respectively.

Children born by AVD were 1.43, 1.46, and 1.41 times more likely than those born by SVD to have total, externalising, and internalising CBCL scores in the highest quartile, respectively.

Conversely, children born by CDMR were less likely to have externalising scores in the highest quartile (adjusted odds ratio [OR] = 0.64) than those born by SVD.

"This association is possibly mediated by the cortisol [stress] response," conclude Liu et al.

MedWire ( is an independent clinical news service provided by Current Medicine Group, a trading division of Springer Healthcare Limited. © Springer Healthcare Ltd; 2010

By Sarah Guy