Risks of attention-deficit/hyperactivity disorder, autism spectrum disorder, and intellectual disability in children delivered by caesarean section: A population-based cohort study

Pei-Yun Lin; Yi-Lung Chen; Ray C Hsiao; Hsiu-Lin Chen; Cheng-Fang Yen

doi:10.1016/j.ajp.2022.103334

Risks of attention-deficit/hyperactivity disorder, autism spectrum disorder, and intellectual disability in children delivered by caesarean section: A population-based cohort study

Asian J Psychiatr. 2023 Feb:80:103334. doi: 10.1016/j.ajp.2022.103334. Epub 2022 Nov 15.

Authors

Pei-Yun Lin¹, Yi-Lung Chen², Ray C Hsiao³, Hsiu-Lin Chen⁴, Cheng-Fang Yen⁵

Affiliations

¹ Department of Psychiatry, Kaohsiung Municipal Siaogang Hospital, Kaohsiung, Taiwan; Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Psychiatry, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
² Department of Psychology, Asia University, Taichung, Taiwan; Department of Healthcare Administration, Asia University, Taichung, Taiwan.
³ Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA, USA; Department of Psychiatry, Seattle Children's, Seattle, WA, USA.
⁴ Department of Respiratory Therapy, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Division of Neonatology, Department of Pediatrics, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan. Electronic address: ch840062@kmu.edu.tw.
⁵ Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Psychiatry, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; College of Professional Studies, National Pingtung University of Science and Technology, Pingtung, Taiwan. Electronic address: p03132006@gmail.com.

PMID: 36436450
DOI: 10.1016/j.ajp.2022.103334

Abstract

This population-based study investigated the risks of attention-deficit/hyperactivity disorder (ADHD), autism spectrum disorder (ASD), and intellectual disabilities among children delivered by Cesarean section (CS) in comparison with those who were delivered by vaginal delivery (VD). The Taiwan Maternal and Child Health Database from 2004 to 2016 registered 675,718 and 1,208,983 children delivered by CS and by VD, respectively. The results of Cox proportional hazards regression model demonstrated that children delivered by CS had significantly higher risks of ADHD, ASD, and intellectual disability than those delivered by VD after the confounding effects of maternal and child factors were controlled for.

Keywords: Attention-deficit/hyperactivity disorder; Autism spectrum disorder; Cesarean section; Intellectual disability; Psychological well-being.

MeSH terms

Attention Deficit Disorder with Hyperactivity* / epidemiology
Autism Spectrum Disorder* / epidemiology
Cesarean Section
Child
Cohort Studies
Female
Humans
Intellectual Disability* / epidemiology
Pregnancy