Conflict of interest statement: No conflicts declared.
Research Review: Birth by caesarean section and development of autism spectrum disorder and attention-deficit/hyperactivity disorder: a systematic review and meta-analysis
Version of Record online: 27 OCT 2014
© 2014 Association for Child and Adolescent Mental Health.
Journal of Child Psychology and Psychiatry
Volume 56, Issue 5, pages 500–508, May 2015
How to Cite
Curran, E. A., O'Neill, S. M., Cryan, J. F., Kenny, L. C., Dinan, T. G., Khashan, A. S. and Kearney, P. M. (2015), Research Review: Birth by caesarean section and development of autism spectrum disorder and attention-deficit/hyperactivity disorder: a systematic review and meta-analysis. Journal of Child Psychology and Psychiatry, 56: 500–508. doi: 10.1111/jcpp.12351
- Issue online: 7 APR 2015
- Version of Record online: 27 OCT 2014
- Manuscript Accepted: 22 SEP 2014
- The Irish Centre for Fetal and Neonatal Translational Research (INFANT). Grant Number: 12|RC|2272
- Autism spectrum disorder;
- attention-deficit/hyperactivity disorder;
- Caesarean section
Given the growing prevalence of birth by Caesarean section (CS) worldwide, it is important to understand any long-term effects CS delivery may have on a child's development. We assessed the impact of mode of delivery on autism spectrum disorders (ASD) and attention-deficit/hyperactivity disorder (ADHD).
We conducted a systematic review of the literature in PubMed, Embase, CINAHL, PsycINFO and Web of Science up to 28 February 2014. No publication date, language, location or age restrictions were employed.
Thirteen studies reported an adjusted estimate for CS-ASD, producing a pooled odds ratio (OR) of 1.23 (95% CI: 1.07, 1.40). Two studies reported an adjusted estimate for CS-ADHD, producing a pooled OR of 1.07 (95% CI: 0.86, 1.33).
Delivery by CS is associated with a modest increased odds of ASD, and possibly ADHD, when compared to vaginal delivery. Although the effect may be due to residual confounding, the current and accelerating rate of CS implies that even a small increase in the odds of disorders, such as ASD or ADHD, may have a large impact on the society as a whole. This warrants further investigation.