目的 评价分娩方式与儿童神经精神发育的关联。方法 采用前瞻性母婴队列研究，于2013年和2014年采 用年龄与发育进程问卷，从沟通、粗大动作、精细运动、解决问题以及个人-社会5个能区评价651名12和24月龄儿童的 神经精神发育状况。以剖宫产为暴露组，阴道分娩为对照组，采用多因素logistic回归分析评估分娩方式与儿童神经精神 发育的关联及关联强度。结果 12和24月龄儿童神经精神发育迟缓发生率分别为3 . 94 %和13 . 12 %。剖宫产对12月龄儿 童神经精神发育无显著影响。调整妊娠期高血压、妊娠期糖尿病和家庭经济收入等因素后，24月龄剖宫产儿童沟通能区 发育迟缓的发生风险显著增加，发病风险为阴道分娩组的3.37倍（95 %CI：1.02~10.5，P

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.