关键词: 分娩方式； 神经精神发育； 队列研究； 年龄与发育进程问卷

Abstract: Objective To explore the association between mode of delivery and neuropsychological development in children. Methods In 2013 and 2014 , neuropsychological development in 651 children of 12 months old and 24 months old was evaluated using the Ages and Stages Questionnaires from five functional areas including communications skills, gross motor, fine motor, problem solving and personal social in a prospective maternal infant cohort study. The children delivered by cesarean section were included in the exposure group, and children delivered by vagina were included in the control group. Multivariate logistic regression analysis was used to evaluate the correlation between delivery mode and children’s neuropsychological development as well as the strength of the association. Results The incidence of neuropsychological development retardation in children of 12 months old and 24 months old was 3 . 94 % and 13 . 12 % respectively. Cesarean section has no significant effect on neuropsychological development of children aged 12 months. After adjusting for the confounding factors such as gestational hypertension, gestational diabetes, and family income, the children delivered by cesarean section had a significantly increased risk of developmental retardation in the communication skills at 24 months of age, 3 . 37 times higher than that in the vaginal delivery group ( 95 %CI: 1 . 02 ~ 10 . 5 , P< 0 . 05 ). Conclusions Cesarean section may increase the risk of developmental retardation in the communication skills at 24 months of age.

Key words: mode of delivery; neuropsychological development; cohort study; ages and stages questionnaires