Caesarean delivery on maternal request and childhood psychopathology: a retrospective cohort study in China
Article first published online: 3 NOV 2010
© 2010 The Authors Journal compilation © RCOG 2010 BJOG An International Journal of Obstetrics and Gynaecology
BJOG: An International Journal of Obstetrics & Gynaecology
Volume 118, Issue 1, pages 42–48, January 2011
How to Cite
Li, H.-T., Ye, R., Achenbach, T., Ren, A., Pei, L., Zheng, X. and Liu, J.-M. (2011), Caesarean delivery on maternal request and childhood psychopathology: a retrospective cohort study in China. BJOG: An International Journal of Obstetrics & Gynaecology, 118: 42–48. doi: 10.1111/j.1471-0528.2010.02762.x
- Issue published online: 10 DEC 2010
- Article first published online: 3 NOV 2010
- Accepted 15 September 2010. Published Online 3 November 2010.
- Caesarean delivery on maternal request;
- mode of delivery;
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.