The aim of this prospective longitudinal study was to examine the association between Cesarean section (CS) and child development and behavior. The sample consisted of 256 children who were born at term without serious perinatal pathologies. Their development and behavior was assessed at the age of four using Ages and Stages Questionnaire (ASQ-3), Children's Behavior Questionnaire and Strength and Difficulties Questionnaire. Multivariate linear regression analyses were conducted to assess the association between CS and child outcomes. CS was associated with better scores in the Problem Solving domain of the ASQ in the whole sample. After stratifying by child sex, the positive association between CS and the Problem Solving domain was significant in boys, while no association was found in girls. Girls were rated less optimally in the Gross Motor domain of the ASQ when born via CS. Mode of birth was not associated with behavioral outcomes.

Amsterdam UMC Vrije Universiteit Amsterdam Department of Midwifery Science AVAG Amsterdam Public Health Research Institute Amsterdam The Netherlands

Department of General Practice and Elderly Medicine University Medical Center Groningen University of Groningen Groningen The Netherlands

Department of Obstetrics and Gynecology and Psychiatry Columbia University New York NY USA

Department of Obstetrics and Gynecology Columbia University New York NY USA

Department of Psychology Bowdoin College Brunswick ME USA

Department of Psychology Faculty of Arts Charles University Prague Czech Republic

New York State Psychiatric Institute New York NY USA

Research in Childbirth and Health Unit School of Community Health and Midwifery Faculty of Health and Care University of Central Lancashire Preston UK

School of Nursing and Midwifery Western Sydney University Sydney Australia

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Weimer KR, Farmer CJ, Reid CE. A spatial view of how United States cesarean section rates changed from 1990 to 2014. Prof Geogr. 2019;71(4):762–769. doi: 10.1080/00330124.2019.1578979. DOI

Betrán AP, Ye J, Moller A-B, Zhang J, Gülmezoglu AM, Torloni MR. The increasing trend in caesarean section rates: global, regional and national estimates: 1990–2014. PLoS ONE. 2016;11(2):e0148343. doi: 10.1371/journal.pone.0148343. PubMed DOI PMC

Sk R, Barua S. Nonclinical factors of cesarean section birth: a review of the literature. Int J Childbirth. 2018;8(2):135–148. doi: 10.1891/2156-5287.8.2.135. DOI

Kirchengast S, Hartmann B. Recent lifestyle parameters are associated with increasing caesarean section rates among singleton term births in Austria. Int J Environ Res Public Health. 2019;16(1):14. doi: 10.3390/ijerph16010014. PubMed DOI PMC

Kozhimannil KB, Graves AJ, Ecklund AM, Shah N, Aggarwal R, Snowden JM. Cesarean delivery rates and costs of childbirth in a state Medicaid program after implementation of a blended payment policy. Med Care. 2018;56(8):658–664. doi: 10.1097/MLR.0000000000000937. PubMed DOI

Keag OE, Norman JE, Stock SJ. Long-term risks and benefits associated with cesarean delivery for mother, baby, and subsequent pregnancies: systematic review and meta-analysis. PLoS Med. 2018;15(1):e1002494. doi: 10.1371/journal.pmed.1002494. PubMed DOI PMC

O’Reilly A, Choby D, Séjourné N, Callahan S. Feelings of control, unconditional self-acceptance and maternal self-esteem in women who had delivered by caesarean. J Reprod Infant Psychol. 2014;32(4):355–365. doi: 10.1080/02646838.2014.930111. DOI

Lai YL, Hung CH, Stocker J, Chan TF, Liu Y. Postpartum fatigue, baby-care activities, and maternal-infant attachment of vaginal and cesarean births following rooming-in. Appl Nurs Res. 2015;28(2):116–120. doi: 10.1016/j.apnr.2014.08.002. PubMed DOI

Dekel S, Ein-Dor T, Berman Z, Barsoumian IS, Agarwal S, Pitman RK. Delivery mode is associated with maternal mental health following childbirth. Arch Women's Ment Health. 2019;22(6):817–824. doi: 10.1007/s00737-019-00968-2. PubMed DOI PMC

Li Y, Tian Y, Zhu W, et al. Cesarean delivery and risk of inflammatory bowel disease: a systematic review and meta-analysis. Scand J Gastroenterol. 2014;49(7):834–844. doi: 10.3109/00365521.2014.910834. PubMed DOI

Hansen AK, Wisborg K, Uldbjerg N, Henriksen TB. Elective caesarean section and respiratory morbidity in the term and near-term neonate. Acta Obstet Gynecol Scand. 2007;86(4):389–394. doi: 10.1080/00016340601159256. PubMed DOI

Bager P, Wohlfahrt J, Westergaard T. Caesarean delivery and risk of atopy and allergic disesase: meta-analyses. Clin Exp Allergy. 2008;38(4):634–642. doi: 10.1111/j.1365-2222.2008.02939.x. PubMed DOI

Cardwell CR, Stene L, Joner G, et al (2008) Caesarean section is associated with an increased risk of childhood-onset type 1 diabetes mellitus: a meta-analysis of observational studies. Diabetologia 51:726–735 PubMed

Cho CE, Norman M. Cesarean section and development of the immune system in the offspring. Am J Obstet Gynecol. 2013;208(4):249–254. doi: 10.1016/j.ajog.2012.08.009. PubMed DOI

Cuppari C, Manti S, Salpietro A, Alterio T, Arrigo T, Leonardi S, Salpietro C (2015) Mode of delivery and risk for development of atopic diseases in children. Allergy Asthma Proc 36(5):344–351 PubMed

Hyde MJ, Mostyn A, Modi N, Kemp PR. The health implications of birth by caesarean section. Biol Rev. 2012;87(1):229–243. doi: 10.1111/j.1469-185X.2011.00195.x. PubMed DOI

Rutayisire E, Kun H, Yehao L, et al. The mode of delivery affects the diversity and colonization pattern of the gut microbiota during the first year of infants' life: a systematic review. BMC Gastroenterol. 2016;16:1–12. doi: 10.1186/s12876-016-0498-0. PubMed DOI PMC

Dahlen HG, Kennedy HP, Anderson CM, et al. The EPIIC hypothesis: intrapartum effects on the neonatal epigenome and consequent health outcomes. Med Hypotheses. 2013;80(5):656–662. doi: 10.1016/j.mehy.2013.01.017. PubMed DOI PMC

Lobel M, DeLuca RS. Psychosocial sequelae of cesarean delivery: review and analysis of their causes and implications. Soc Sci Med. 2007;64(11):2272–2284. doi: 10.1016/j.socscimed.2007.02.028. PubMed DOI

Gonzalez-Valenzuela MJ, Gonzalez-Mesa E, Cazorla-Granados O, Lopez-Montiel D. Type of delivery, neuropsychological development and intelligence in twin births. Front Psychol. 2019;10:972. doi: 10.3389/fpsyg.2019.00972. PubMed DOI PMC

Polidano C, Zhu A, Bornstein JC. The relation between cesarean birth and child cognitive development. Sci Rep. 2017;7(1):11483–11583. doi: 10.1038/s41598-017-10831-y. PubMed DOI PMC

Al Khalaf SY, O’Neill SM, O’Keeffe LM, et al. The impact of obstetric mode of delivery on childhood behavior. Soc Psychiatry Psychiatr Epidemiol. 2015;50(10):1557–1567. doi: 10.1007/s00127-015-1055-9. PubMed DOI

Grace T, Bulsara M, Robinson M, Hands B. Early life events and motor development in childhood and adolescence: a longitudinal study. Acta Paediatr. 2016;105(5):e219–e227. doi: 10.1111/apa.13302. PubMed DOI

Sucksdorff M, Lehtonen L, Chudal R, Suominen A, Gissler M, Sourander A. Lower Apgar scores and Caesarean sections are related to attention-deficit/hyperactivity disorder. Acta Paediatr. 2018;107(10):1750–1758. doi: 10.1111/apa.14349. PubMed DOI

Yip BHK, Leonard H, Stock S, et al. Caesarean section and risk of autism across gestational age: a multi-national cohort study of 5 million births. Int J Epidemiol. 2017;46(2):429–439. doi: 10.1093/ije/dyw336. PubMed DOI PMC

Curran EA, Cryan JF, Kenny LC, Dinan TG, Kearney PM, Khashan AS. Obstetrical mode of delivery and childhood behavior and psychological development in a British cohort. J Autism Dev Disord. 2016;46(2):603–614. doi: 10.1007/s10803-015-2616-1. PubMed DOI

Huberman Samuel M, Meiri G, Dinstein I, et al. Exposure to general anesthesia may contribute to the association between cesarean delivery and autism spectrum disorder. J Autism Dev Disord. 2019;49(8):3127–3135. doi: 10.1007/s10803-019-04034-9. PubMed DOI

Leung CY, Leung GM, Schooling CM. Mode of delivery and child and adolescent psychological well-being: evidence from Hong Kong's "Children of 1997" birth cohort. Sci Rep. 2017;7(1):15673–15773. doi: 10.1038/s41598-017-15810-x. PubMed DOI PMC

Smithers LG, Mol BW, Wilkinson C, Lynch JW. Implications of caesarean section for children's school achievement: a population-based study. Aust N Z J Obstet Gynaecol. 2016;56(4):374–380. doi: 10.1111/ajo.12475. PubMed DOI

Li HT, Ye R, Achenbach TM, et al. Caesarean delivery on maternal request and childhood psychopathology: a retrospective cohort study in China. BJOG. 2011;118(1):42–48. doi: 10.1111/j.1471-0528.2010.02762.x. PubMed DOI

Robson SJ, Vally H, Abdel-Latif ME, Yu M, Westrupp E. Childhood health and developmental outcomes after cesarean birth in an Australian Cohort. Pediatrics. 2015;136(5):e1285–e1293. doi: 10.1542/peds.2015-1400. PubMed DOI

Simons CJ, Ritchie SK, Mullett MD. Relationships between parental ratings of infant temperament, risk status, and delivery method. J Pediatr Health Care. 1992;6(5 Pt 1):240–245. doi: 10.1016/0891-5245(92)90021-U. PubMed DOI

Rihmer Z, Akiskal KK, Rihmer A, Akiskal HS. Current research on affective temperaments. Curr Opin Psychiatry. 2010;23(1):12–18. doi: 10.1097/YCO.0b013e32833299d4. PubMed DOI

Shiner RL, Buss KA, McClowry SG, Putnam SP, Saudino KJ, Zentner M. What is temperament now? Assessing progress in temperament research on the Twenty-Fifth Anniversary of Goldsmith et al.() Child Dev Persp. 2012;6(4):436–444.

Putnam SP, Rothbart MK. Development of short and very short forms of the Children's Behavior Questionnaire. J Pers Assess. 2006;87(1):102–112. doi: 10.1207/s15327752jpa8701_09. PubMed DOI

Gartstein MA, Putnam SP, Rothbart MK. Etiology of preschool behavior problems: contributions of temperament attributes in early childhood. Infant Ment Health J. 2012;33(2):197–211. doi: 10.1002/imhj.21312. PubMed DOI

Huang K, Yan S, Wu X, Zhu P, Tao F. Elective caesarean section on maternal request prior to 39 gestational weeks and childhood psychopathology: a birth cohort study in China. BMC Psychiatry. 2019;19(1):22. doi: 10.1186/s12888-019-2012-z. PubMed DOI PMC

Rutayisire E, Wu X, Huang K, Tao S, Chen Y, Tao F. Childhood emotional and behavior problems and their associations with cesarean delivery. Braz J Psychiatry. 2018;40(2):145–153. doi: 10.1590/1516-4446-2016-2152. PubMed DOI PMC

Kelmanson IA. Emotional and behavioural features of preschool children born by caesarean deliveries at maternal request. Eur J Dev Psychol. 2013;10(6):676–690. doi: 10.1080/17405629.2013.787024. DOI

Achenbach TM, Ivanova MY, Rescorla LA, Turner LV, Althoff RR. Internalizing/externalizing problems: review and recommendations for clinical and research applications. J Am Acad Child Adolesc Psychiatry. 2016;55(8):647–656. doi: 10.1016/j.jaac.2016.05.012. PubMed DOI

Goodman A, Lamping DL, Ploubidis GB. When to use broader internalising and externalising subscales instead of the hypothesised five subscales on the Strengths and Difficulties Questionnaire (SDQ): data from British parents, teachers and children. J Abnorm Child Psychol. 2010;38(8):1179–1191. doi: 10.1007/s10802-010-9434-x. PubMed DOI

Jasiulione JS, Jusiene R (2019) Delivery mode, maternal characteristics, and developmental trajectories of toddlers’ emotional and behavioral problems. Child Youth Care Forum 48(3):405–425

Takács L, Smolík F, Putnam S. Assessing longitudinal pathways between maternal depressive symptoms, parenting self-esteem and infant temperament. PLoS ONE. 2019;14(8):e0220633. doi: 10.1371/journal.pone.0220633. PubMed DOI PMC

Squires J, Bricker D. Ages & stages questionnaires, (ASQ-3). A parent-completed child monitoring system. 3. Baltimore, MD: Brookes; 2009.

Schonhaut L, Martinez-Nadal S, Armijo I, Demestre X. Reliability and agreement of ages and stages questionnaires®: results in late preterm and term-born infants at 24 and 48 months. Early Hum Dev. 2019;128:55–61. doi: 10.1016/j.earlhumdev.2018.11.008. PubMed DOI

Stone LL, Otten R, Engels RC, Vermulst AA, Janssens JM. Psychometric properties of the parent and teacher versions of the strengths and difficulties questionnaire for 4-to 12-year-olds: a review. Clin Child Fam Psychol Rev. 2010;13(3):254–274. doi: 10.1007/s10567-010-0071-2. PubMed DOI PMC

Wahl RUR. Could oxytocin administration during labor contribute to autism and related behavioral disorders?–a look at the literature. Med Hypotheses. 2004;63(3):456–460. doi: 10.1016/j.mehy.2004.03.008. PubMed DOI

Park M, Brain U, Grunau RE, Diamond A, Oberlander TF. Maternal depression trajectories from pregnancy to 3 years postpartum are associated with children's behavior and executive functions at 3 and 6 years. Arch Womens Ment Health. 2018;21(3):353–363. doi: 10.1007/s00737-017-0803-0. PubMed DOI

Beck AT, Steer RA, Brown GK. Beck depression inventory-II. San Antonio. 1996;78(2):490–498.

Ptáček R, Raboch J, Vňuková M, Hlinka J, Anders M. Beckova škála deprese BDI-II-Standardizace a využití v praxi. Ceská a Slovenská Psychiatrie. 2016;112(6):270–274.

Mondal D, Galloway TS, Bailey TC, Mathews F. Elevated risk of stillbirth in males: systematic review and meta-analysis of more than 30 million births. BMC Med. 2014;12(1):220. doi: 10.1186/s12916-014-0220-4. PubMed DOI PMC

Galjaard S, Ameye L, Lees CC, et al. Sex differences in fetal growth and immediate birth outcomes in a low-risk Caucasian population. Biol Sex Differ. 2019;10(1):48. doi: 10.1186/s13293-019-0261-7. PubMed DOI PMC

Hands B, Kendall G, Larkin D, Parker H. Perinatal risk factors for mild motor disability. Int J Disabil Dev Educ. 2009;56(4):317–331. doi: 10.1080/10349120903306533. DOI

Jenabi E, Khazaei S, Bashirian S, Aghababaei S, Matinnia N. Reasons for elective cesarean section on maternal request: a systematic review. J Mater Fetal Neonatal Med. 2019 doi: 10.1080/14767058.2019.1587407. PubMed DOI

Parity moderates the effect of delivery mode on maternal ratings of infant temperament