Ce­sarean de­liv­ery won’t harm kids’ health –study

Daily Trust - - HEALTH -

In a study of more than 5,000 chil­dren, Aus­tralian re­searchers said they found that ce­sarean sec­tion de­liv­ery was not linked with a higher risk of health prob­lems in child­hood.

“This study sug­gests that some of the pre­vi­ously re­ported as­so­ci­a­tions be­tween birth by ce­sarean de­liv­ery and ad­verse child­hood health out­comes may be ex­plained by in­flu­ences other than mode of birth,” said lead re­searcher El­iz­a­beth Westrupp, a re­search fel­low in the School of Nurs­ing at La Trobe Univer­sity in Mel­bourne.

The re­searchers con­cluded that ce­sarean de­liv­ery was as­so­ci­ated with a mix of pos­i­tive and neg­a­tive out­comes through early child­hood, and few were con­sis­tent.

For ex­am­ple, the as­so­ci­a­tion be­tween ce­sarean de­liv­ery and child­hood obe­sity might ac­tu­ally be ex­plained by the mother’s obe­sity, Westrupp said.

“These find­ings should be re­as­sur­ing to women and their doc­tors,” she added.

The re­port was pub­lished online Oct. 12 in the jour­nal Pe­di­atrics.

For the study, Westrupp and her col­leagues used data on more than 5,100 kids born in Aus­tralia in 2003 and 2004. The chil­dren were fol­lowed to the age of 7 years.

Specif­i­cally, re­searchers looked at over­all health and con­di­tions such as asthma and body weight. They also looked at med­i­ca­tions chil­dren were tak­ing, any dis­abil­i­ties or med­i­cal prob­lems, and so­cial and eco­nomic cir­cum­stances.

The re­searchers then ad­justed their find­ings to take into ac­count the mother’s so­cial en­vi­ron­ment and weight, and whether the child was breast-fed.

Ini­tially, Westrupp’s team found that chil­dren born by C-sec­tion were more likely to have a med­i­cal con­di­tion at age 2 or 3, use pre­scribed drugs at age 6 or 7, and to weigh more at age 8 or 9.

How­ever, the child’s ex­cess body weight re­flected the mother’s obe­sity, not be­ing born by C-sec­tion, Westrupp said.

And ce­sarean de­liv­ery was linked with bet­ter over­all health at age 2 or 3 and bet­ter so­cial skills at age 6 or 7, the re­searchers re­ported.

When Westrupp’s group took into ac­count fac­tors not re­lated to de­liv­ery method, the as­so­ci­a­tion be­tween child­hood health and C-sec­tions tended to weaken even fur­ther.

“When we took into ac­count fac­tors re­lated to birth, so­cial disad­van­tage, ma­ter­nal weight and breast-feed­ing, we found few as­so­ci­a­tions be­tween ce­sarean birth and child out­comes,” she said.

Dr. Aaron Caughey, chair of the depart­ment of ob­stet­rics and gyne­col­ogy at Ore­gon Health & Science Univer­sity in Port­land, said, “I don’t think we should be do­ing ce­sarean de­liv­er­ies with­out a med­i­cal in­di­ca­tion. But just be­cause you ended up need­ing a C-sec­tion I don’t think that you should be wor­ried that your child can suf­fer some longterm con­se­quences.”

Scant ev­i­dence ex­ists to sup­port the idea that C-sec­tions can be bad for the health of the in­fant, he added.

How­ever, Caughey said that although a C-sec­tion might not hurt the in­fant, it can be prob­lem­atic for the mother.

“If you make a hole into some­one’s body all sorts of bad things can hap­pen,” he said. These can in­clude dam­age to or­gans, ex­cess bleed­ing and in­fec­tion. Af­ter a C-sec­tion, a woman also ex­pe­ri­ences a lot of pain.

That doesn’t mean that there aren’t good rea­sons to have a ce­sarean de­liv­ery, Caughey said. “In some cases, it is ab­so­lutely life­sav­ing for both the baby and the mother,” he said.

Med­i­cal rea­sons for a C-sec­tion in­clude hav­ing had a pre­vi­ous ce­sarean de­liv­ery, sit­u­a­tions where the baby is not cor­rectly po­si­tioned in the womb and prob­lems with the in­fant’s heart func­tion.

Still, Caughey be­lieves that too many women are hav­ing their ba­bies de­liv­ered by C-sec­tion. For the past sev­eral years, groups like the Amer­i­can Congress of Ob­ste­tri­cians and Gyne­col­o­gists have been ad­vo­cat­ing for fewer C-sec­tions, he said.

“We have en­cour­aged doc­tors to be thought­ful and not do C-sec­tions willy-nilly,” Caughey noted.

Since 2010, the num­ber of C-sec­tions has lev­eled off, he said. “In 2014, it was 0.5 per­cent lower than in 2013, drop­ping from 32.7 per­cent to 32.2 per­cent. It’s the big­gest drop we’ve seen in 20 years -that’s 20,000 fewer C-sec­tions.”

Among women who have never had a ce­sarean de­liv­ery, the rate of C-sec­tions shouldn’t be above 15 per­cent, Caughey said. “In most hos­pi­tals, it’s above 20 per­cent,” he said.

“A woman should work with her doc­tor and mid­wife and think about the process and what’s best for her,” Caughey said. “We think that it’s gen­er­ally safe to have a vagi­nal de­liv­ery.”

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