Relations between mode of birth delivery and timing of developmental milestones and adiposity in preadolescence: A retrospective study

Morgan R Chojnacki, Hannah D Holscher, Alaina R Balbinot, Lauren B Raine, John R Biggan, Anne M Walk, Arthur F Kramer, Neal J Cohen, Charles H Hillman, Naiman A Khan, Morgan R Chojnacki, Hannah D Holscher, Alaina R Balbinot, Lauren B Raine, John R Biggan, Anne M Walk, Arthur F Kramer, Neal J Cohen, Charles H Hillman, Naiman A Khan

Abstract

Background: Cesarean delivery (CS) is an increasingly common mode of delivery comprising over 30% of all deliveries in the U.S. The long-term impact of this delivery mode on child development remains unclear.

Aims: We investigated the relationship between mode of delivery (vaginal vs. CS) and timing of developmental milestones and adiposity in preadolescence, as well as additional milestones beyond motor/language development including toilet training, dressing, and feeding self.

Study design: This study utilized a retrospective survey given to a parent/guardian and dual energy x-ray absorptiometry in preadolescence, respectively. A composite z-score was calculated based on nine questions pertaining to developmental milestones i.e., parent-reported age for supporting head by self, rolling over, sitting up, standing, walking, talking, toilet-training, dressing, and feeding self.

Subjects: 7-10-year-old (N = 104) children in East-Central Illinois.

Outcome measures: Composite z-score for timing of attainment of developmental milestones, mode of delivery, and preadolescent adiposity.

Results: Vaginally-born children had a lower composite z-score, signifying earlier attainment of developmental milestones, relative to both emergency and planned CS-born children. Further, elective CS-born children had greater adiposity in preadolescence, relative to vaginal and emergency cesarean-section born children.

Conclusions: These findings suggest relationships between delivery mode, developmental milestones, and obesity in preadolescence. Additionally, they provide novel insights into the differential impact of elective versus emergency CS.

Trial registration: ClinicalTrials.gov NCT01334359 NCT01619826.

Keywords: Birth method; Cesarean section; Developmental milestones; Gross motor development; Language development; Mode of delivery; Vaginal delivery.

Copyright © 2019 Elsevier B.V. All rights reserved.

Figures

Figure 1:
Figure 1:
Bar graph depicting the ANOVA results (Bonferroni corrected) for differences between groups (vaginal birth, emergency CS, and elective CS) on the age at which developmental milestones are reached. Differing letters indicate significant differences between groups (p

Figure 2:

Bar graph depicting the ANOVA…

Figure 2:

Bar graph depicting the ANOVA results (Bonferroni corrected) for differences between groups (vaginal…

Figure 2:
Bar graph depicting the ANOVA results (Bonferroni corrected) for differences between groups (vaginal birth, emergency CS, and elective CS) on the z Score for reaching developmental milestones. Differing letters indicate significant differences between groups (p

Figure 3:

Bar graph depicting the ANOVA…

Figure 3:

Bar graph depicting the ANOVA results (Bonferroni corrected) for differences between groups (vaginal…

Figure 3:
Bar graph depicting the ANOVA results (Bonferroni corrected) for differences between groups (vaginal birth, emergency CS, and elective CS) and %Fat mass at preadolescence. Differing letters indicate significant differences between groups (p

Figure 4:

Bar graph depicting the ANOVA…

Figure 4:

Bar graph depicting the ANOVA results (Bonferroni corrected) for differences between mode of…

Figure 4:
Bar graph depicting the ANOVA results (Bonferroni corrected) for differences between mode of delivery and central adiposity at preadolescence. Differing letters indicate significant differences between groups (p
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Figure 2:
Figure 2:
Bar graph depicting the ANOVA results (Bonferroni corrected) for differences between groups (vaginal birth, emergency CS, and elective CS) on the z Score for reaching developmental milestones. Differing letters indicate significant differences between groups (p

Figure 3:

Bar graph depicting the ANOVA…

Figure 3:

Bar graph depicting the ANOVA results (Bonferroni corrected) for differences between groups (vaginal…

Figure 3:
Bar graph depicting the ANOVA results (Bonferroni corrected) for differences between groups (vaginal birth, emergency CS, and elective CS) and %Fat mass at preadolescence. Differing letters indicate significant differences between groups (p

Figure 4:

Bar graph depicting the ANOVA…

Figure 4:

Bar graph depicting the ANOVA results (Bonferroni corrected) for differences between mode of…

Figure 4:
Bar graph depicting the ANOVA results (Bonferroni corrected) for differences between mode of delivery and central adiposity at preadolescence. Differing letters indicate significant differences between groups (p
Similar articles
Cited by
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Associated data
[x]
Cite
Copy Download .nbib
Format: AMA APA MLA NLM

NCBI Literature Resources

MeSH PMC Bookshelf Disclaimer

The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). Unauthorized use of these marks is strictly prohibited.

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Figure 3:
Figure 3:
Bar graph depicting the ANOVA results (Bonferroni corrected) for differences between groups (vaginal birth, emergency CS, and elective CS) and %Fat mass at preadolescence. Differing letters indicate significant differences between groups (p

Figure 4:

Bar graph depicting the ANOVA…

Figure 4:

Bar graph depicting the ANOVA results (Bonferroni corrected) for differences between mode of…

Figure 4:
Bar graph depicting the ANOVA results (Bonferroni corrected) for differences between mode of delivery and central adiposity at preadolescence. Differing letters indicate significant differences between groups (p
Similar articles
Cited by
Publication types
Associated data
[x]
Cite
Copy Download .nbib
Format: AMA APA MLA NLM
Figure 4:
Figure 4:
Bar graph depicting the ANOVA results (Bonferroni corrected) for differences between mode of delivery and central adiposity at preadolescence. Differing letters indicate significant differences between groups (p

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