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Caesarean delivery on maternal request and childhood psychopathology: a retrospective cohort study in China

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Abstract:

Please cite this paper as: Li H-T, Ye R, Achenbach T, Ren A, Pei L, Zheng X, Liu J-M. Caesarean delivery on maternal request and childhood psychopathology: a retrospective cohort study in China. BJOG 2011;118:42–48. Objective 

To prospectively examine the association between mode of delivery and childhood psychopathology. Design 

Retrospective cohort study. Setting 

Eighteen counties and three cities in China. Population 

A total of 4190 preschool children whose mothers were registered in a perinatal surveillance programme were assessed with the Child Behaviour Checklist (CBCL), an instrument to assess child emotional (internalising) and behavioural (externalising) problems. Methods 

Differences in CBCL problem scores were analysed both quantitatively and categorically among children born by caesarean delivery on maternal request (CDMR), assisted vaginal delivery (AVD), and spontaneous vaginal delivery (SVD). Main outcome measures 

The CBCL total, externalising, and internalising scores. Results 

There were significant differences in the mean scores of total (20.9, 23.0, and 25.0), externalising (7.6, 8.4, and 9.1), and internalising (4.7, 5.2, and 5.6) problems among children born by CDMR, SVD, and AVD, after adjusting for potential confounding factors (P = 0.007, 0.014, and 0.031). Children born by AVD were more likely than those born by SVD to have total (OR 1.43; 95% CI 1.10–1.86), externalising (OR 1.46; 95% CI 1.11–1.92), and internalising (OR 1.41; 95% CI 1.08–1.84) scores in the highest quartile, whereas children born by CDMR were less likely to have externalising scores in the highest quartile (OR 0.64; 95% CI 0.42–0.97). Furthermore, there were significant increasing linear trends on all problem scores, and in the odds of being in the highest quartile, from children born by CDMR to those born by SVD and AVD. Conclusion 

The likelihood of childhood psychopathological problems may be the lowest in children born by CDMR, followed by those born by SVD, whereas the highest probability was observed in those born by AVD.

Keywords: Caesarean delivery on maternal request; childhood; mode of delivery; psychopathology

Document Type: Research Article

DOI: https://doi.org/10.1111/j.1471-0528.2010.02762.x

Affiliations: 1: Department of Epidemiology 2: Department of Surveillance and Data Management, Institute of Reproductive and Child Health, Peking University Health Science Center, Beijing, China 3: Department of Psychiatry, University of Vermont, Bington, USA 4: Department of Health Promotion, Institute of Reproductive and Child Health, Peking University Health Science Center, Beijing, China 5: Peking University Institute of Population Research/WHO Collaborating Center on Reproductive Health and Population Science, Beijing, China

Publication date: 2011-01-01

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