ArticleInternational journal of epidemiology2017
Caesarean section and risk of autism across gestational age: a multi-national cohort study of 5 million births.
Article in International journal of epidemiology, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 38 papers, 3 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
38 citing papers in PubMed, 3 syntheses or guidelines pooled it, 74 citations in OpenAlex.
- Effect of cesarean section on the risk of autism spectrum disorders/attention deficit hyperactivity disorder in offspring: a meta-analysis.Archives of gynecology and obstetrics · 2024Pooled it
- Maternal polycystic ovarian syndrome in autism spectrum disorder: a systematic review and meta-analysis.Molecular psychiatry · 2019Pooled it
- Association of Cesarean Delivery With Risk of Neurodevelopmental and Psychiatric Disorders in the Offspring: A Systematic Review and Meta-analysis.JAMA network open · 2019Pooled it
- Long-Term Neurodevelopmental Outcomes After Forceps, Vacuum, and Second-Stage Cesarean Delivery.JAMA network open · 2026Article
- Article
- Impact of maternal microbiota imbalance during pregnancy on fetal cerebral neurodevelopment: Is there a link to certain autistic disorders?Brain, behavior, & immunity - health · 2025Review
- Risk Factors for Autism Spectrum Disorder in Individuals Born Preterm: A Systematic Review and Meta-Analysis of Population-Based Studies.Biological psychiatry global open science · 2025Article
- The Effects of Fecal Microbial Transplantation on the Symptoms in Autism Spectrum Disorder, Gut Microbiota and Metabolites: A Scoping Review.Microorganisms · 2025Review
- Modified neuroimmune processes and emotional behaviour in weaned and late adolescent male and female mice born via caesarean section.Scientific reports · 2024Article
- Malpresentation and autism spectrum disorder in the study to explore early development.Paediatric and perinatal epidemiology · 2024Article
- Between Dysbiosis, Maternal Immune Activation and Autism: Is There a Common Pathway?Nutrients · 2024Review
- Environmental Risk Factors in Autism Spectrum Disorder: A Narrative Review.Current medicinal chemistry · 2024Review
- Cesarean section induced dysbiosis promotes type 2 immunity but not oxazolone-induced dermatitis in mice.Gut microbes · 2023Article
- Review
- Lasting consequences on physiology and social behavior following cesarean delivery in prairie voles.Hormones and behavior · 2023Article
- Physical Activity, Gut Microbiota, and Genetic Background for Children and Adolescents with Autism Spectrum Disorder.Children (Basel, Switzerland) · 2022Review
- Maternal Mid-Gestation Cytokine Dysregulation in Mothers of Children with Autism Spectrum Disorder.Journal of autism and developmental disorders · 2022Article
- Sex-specific relationships of the infant microbiome and early-childhood behavioral outcomes.Pediatric research · 2022Article
- Impact of caesarean delivery on children's autism-like behaviours: the mediation of exclusive breastfeeding.International breastfeeding journal · 2022Article
- Association between autism spectrum disorder and peripartum events: a case-control study.Revista paulista de pediatria : orgao oficial da Sociedade de Pediatria de Sao Paulo · 2022Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors at 8 institutions in 8 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: The positive association between caesarean section (CS) and autism spectrum disorder (ASD) may be attributed to preterm delivery. However, due to lack of statistical power, no previous study thoroughly examined this association across gestational age. Moreover, most studies did not differentiate between emergency and planned CS. Methods: Using population-based registries of four Nordic countries and Western Australia, our study population included 4 987 390 singletons surviving their first year of life, which included 671 646 CS deliveries and 31 073 ASD children. We used logistic regression to estimate odds ratios (OR) and their 95% confidence intervals (CI) for CS, adjusted for gestational age, site, maternal age and birth year. Stratified analyses were conducted by both gestational age subgroups and by week of gestation. We compared emergency versus planned CS to investigate their potential difference in the risk of ASD. Results: Compared with vaginal delivery, the overall adjusted OR for ASD in CS delivery was 1.26 (95% CI 1.22-1.30). Stratified ORs were 1.25 (1.15-1.37), 1.16 (1.09-1.23), 1.34 (1.28-1.40) and 1.17 (1.04-1.30) for subgroups of gestational weeks 26-36, 37-38, 39-41 and 42-44, respectively. CS was significantly associated with risk of ASD for each week of gestation, from week 36 to 42, consistently across study sites (OR ranged 1.16-1.38). There was no statistically significant difference between emergency and planned CS in the risk of ASD. Conclusion: Across the five countries, emergency or planned CS is consistently associated with a modest increased risk of ASD from gestational weeks 36 to 42 when compared with vaginal delivery.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.