SynthesisSocial psychiatry and psychiatric epidemiology2021
The association of birth by caesarean section and cognitive outcomes in offspring: a systematic review.
Synthesis in Social psychiatry and psychiatric epidemiology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed, 23 citations in OpenAlex.
- Review
- Cesarean Section, Childhood Health, and Schooling: Quasi-Experimental Evidence From Denmark, Norway and Sweden.Health economics · 2025Article
- Understanding the interplay of Caesarean delivery and genetic influences on intelligence and anxiety traits in offspring findings from genome-wide association studies.European journal of obstetrics & gynecology and reproductive biology: X · 2025Review
- Cesarean delivery on child health and development in Japanese nationwide birth cohort.Scientific reports · 2025Article
- Is There an Association Between Cesarean Section Delivery with Specific Learning Disabilities (SLD) or/and Attention-Deficit/Hyperactivity Disorder (ADHD)? A Cross-Sectional Study in Greek Population.Children (Basel, Switzerland) · 2024Article
- Influence of Mode of Delivery on Children's Attention Deficit Hyperactivity Disorder and Childhood Intelligence.Psychiatry investigation · 2023Article
- Association between Socioeconomic Status and Vision Screening Outcomes among Preschool Children in Klang Valley, Malaysia: A Cross-Sectional Study.The Malaysian journal of medical sciences : MJMS · 2022Article
- Caesarean section and its relationship to offspring general cognitive ability: a registry-based cohort study of half a million young male adults.Evidence-based mental health · 2022Article
- From Short- to Long-Term Effects of C-Section Delivery on Microbiome Establishment and Host Health.Microorganisms · 2021Review
- Are there adverse outcomes for child health and development following caesarean section delivery? Can we justify using elective caesarean section to prevent obstetric pelvic floor damage?International urogynecology journal · 2021Review
- Parity moderates the effect of delivery mode on maternal ratings of infant temperament.PloS one · 2021Article
- The effect of very preterm birth on the Five-Factor Model of personality traits: A meta-analysis of individual participant data.European journal of personalityArticle
Corrections and comments
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Authors and funding
4 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeStudies have reported children born by caesarean section are more likely to have lower cognitive outcomes compared to those born by vaginal delivery. This paper reviews the literature examining caesarean birth and offspring cognitive outcomes.
methodsA systematic search for observational studies or case-control studies that compared cognitive outcomes of people born by caesarean section with those born by vaginal delivery was conducted in six databases (Medline, PubMed, EMBASE, PsychInfo, CINAHL, Web of Science) from inception until December 2019 according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Studies were assessed for quality and a narrative synthesis was undertaken considering the evidence for a causal relationship according to the Bradford Hill Criteria.
resultsA total of seven studies were identified. Of these, four found a significant association between elective and emergency caesarean birth and reduction in offspring cognitive performance as measured by school performance or validated cognitive testing. Three studies found no association. There was variability in the quality of the studies, assessment of the reason for caesarean section (emergency vs elective), measurement of outcomes and adjustment for confounding factors.
conclusionThe evidence of an association between CS birth and lower offspring cognitive functioning is inconsistent. Based on currently available data, there is no evidence that a causal association exists. To better examine this association, future studies should (a) distinguish elective and emergency caesareans, (b) adequately adjust for confounding variables and (c) have valid outcome measures of cognition.
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