@article{0cd93b2318b44737a243a1e05e4e5f17,
title = "Associations of caesarean delivery and the occurrence of neurodevelopmental disorders, asthma or obesity in childhood based on Taiwan birth cohort study",
abstract = "Objectives Whether birth by caesarean section (CS) increases the occurrence of neurodevelopmental disorders, asthma or obesity in childhood is controversial. We tried to demonstrate the association between children born by CS and the occurrence of the above three diseases at the age of 5.5 years. Methods The database of the Taiwan Birth Cohort Study which was designed to assess the developmental trajectories of 24 200 children born in 2005 was used in this study. Associations between children born by CS and these three diseases were evaluated before and after controlling for gestational age (GA) at birth, children's characteristics and disease-related predisposing factors. Results Children born by CS had significant increases in neurodevelopmental disorders (20%), asthma (14%) and obesity (18%) compared with children born by vaginal delivery. The association between neurodevelopmental disorders and CS was attenuated after controlling for GA at birth (OR 1.15; 95% CI 0.98 to 1.34). Occurrence of neurodevelopmental disorders steadily declined with increasing GA up to =40-42 weeks. CS and childhood asthma were not significantly associated after controlling for parental history of asthma and GA at birth. Obesity in childhood remained significantly associated with CS (OR 1.13; 95% CI 1.04 to 1.24) after controlling for GA and disease-related factors. Conclusions Our results implied that the association between CS birth and children's neurodevelopmental disorders was significantly influenced by GA. CS birth was weakly associated with childhood asthma since parental asthma and preterm births are stronger predisposing factors. The association between CS birth and childhood obesity was robust after controlling for disease-related factors.",
author = "Ginden Chen and Chiang, {Wan Lin} and Shu, {Bih Ching} and Guo, {Yue Leon} and Chiou, {Shu Ti} and Chiang, {Tung Liang}",
note = "Funding Information: Funding Sponsored by the Health Promotion Administration, Department of Health and Welfare in Taiwan (DOH94&HP&1802, DOH95&HP&1802, DOH96&HP&1702, and DOH99&HP&1702). Funding Information: Data used in this study were derived from the TBCS. The TBCS has been designed to assess the developmental trajectories of Taiwanese children and was financially sponsored by the Health Promotion Administration in Taiwan. The study protocol and questionnaires were approved by the Directorate-General of Budget, Accounting and Statistics in the Executive Yuan, according to the Statistics Act of Taiwan. This study was approved by the Institutional Review Board at the National Taiwan University Hospital (No. 201604055RINC). Funding Information: 1Institute of Health Policy and Management, College of Public Health, National Taiwan University, Taipei, Taiwan 2Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan 3Department of Obstetrics and Gynecology, Chung Shan Medical University Hospital, Taichung, Taiwan 4Department of Institute of Allied Health Sciences, National Cheng Kung University, Tainan, Taiwan 5Department of Environmental and Occupational Medicine, National Taiwan University (NTU) College of Medicine and NTU Hospital, Taipei, Taiwan 6Health Promotion Administration, Ministry of Health and Welfare, Taipei, Taiwan Acknowledgements We appreciate Dr Jeng-Dau Tsai from the Department of Pediatrics and Dr Vincent Chin-Hung Chen from the Department of Psychiatry at Chung Shan Medical University Hospital for kindly providing their expert opinion to help us interpret and classify our findings on neurodevelopmental disorders. We thank all the children and their parents who participated in this study, the interviewers who helped with data collection and all of the study groups who participated in the TBCS. Publisher Copyright: {\textcopyright} Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017.",
year = "2017",
month = sep,
day = "1",
doi = "10.1136/bmjopen-2017-017086",
language = "English",
volume = "7",
journal = "BMJ Open",
issn = "2044-6055",
publisher = "BMJ Publishing Group",
number = "9",
}