Does cesarean delivery increase the occurrence of neurodevelopmental disorders in childhood?

Objective This study aimed to investigate whether cesarean delivery (CD) is associated with the occurrence of neurodevelopmental disorders (NDDs) at the age of 8 years. Methods A total of 19 142 children were included from the Taiwan Birth Cohort Study (TBCS) database. Associations between modes of delivery or modalities of CD and NDDs were evaluated before and after controlling for gestational age (GA) and clinical condition at birth, children's characteristics, maternal socioeconomic status and maternal clinical condition at childbirth. Results The odds ratio (OR) of occurrence of NDDs in children born via CD was 1.15 and the 95% confidence interval (CI) was 1.00-1.32. Emergency CD had a higher occurrence of NDDs (OR: 1.38; 95% CI: 1.16-1.65) compared with vaginal delivery. These associations were attenuated after controlling for children's and maternal characteristics and GA at birth. GA at birth had a significant reverse dose-effect on the occurrence of NDDs in children born via vaginal delivery and CD. Conclusion Modes of delivery and GA could influence the occurrence of NDDs in childhood. However, association of risk of NDDs and modes of delivery or modalities of CD might be modified by males, lower socioeconomic status and mothers with gestational diabetes mellitus.