Concern over caesarean birth study claims

Senior clinicians are urging people not to jump to conclusions about the effects of caesarean births on children later in life, following claims made in a study by Melbourne University researchers.

The study said caesarean born children could have developmental delays in grammar, numeracy and literacy later in life compared with children born by vaginal delivery.

The study used the NAPLAN test results of 5,000 year 3 students and found the delays were equivalent to a child missing more than a month of a school year.

It said, 

Across several measures, we find that cesarean-born children perform significantly below vaginally-born children, by up to a tenth of a standard deviation in national numeracy test scores at age 8–9.
Report: "The relation between cesarean birth and child cognitive development."

One of the authors, Dr Cain Polidano told the ABC the results are significant.

"There is already a bit of evidence that shows that caesarean birth is related to a number of negative childhood health outcomes, including risks of ADHD, autism and also asthma", Dr Polidano said.

"Our research speaks to that literature which shows that there's a link, but what we do now is look at impacts on another outcome, which is child development."

Bupa's Chief Medical Officer, Dr Paul Bates says people should be careful about drawing conclusions from just one isolated study.

Dr Paul Bates, Chief Medical Officer at Bupa Australia & New Zealand
There's no doubt that for healthy women a vaginal birth represents the preferred and safest way of delivering a baby. But we urge caution when looking at isolated studies based on data correlations.
Dr Paul Bates, Chief Medical Officer at Bupa Australia & New Zealand

"There's good population-based evidence that in Australia, too many caesarean sections are being performed," said Dr Bates. "But in the case of medical emergencies or high risk pregnancies, a c-section is usually the best choice."

Professor Ian Hickie, the co-director at the Brain and Mind Centre at the University of Sydney, called the sutdy speculative.

"I think there is a real danger here of this going out to the public and saying that we have shown a direct association," Professor Hickie told the ABC.

"At this stage what we know is that the appropriate use of caesarean births saves lives, maternal and child. Also that caesareans are associated with high risk pregnancies … because it was a pregnancy at risk in the first place."

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