A Retrospective Cohort Study About The Effect Of Elective Cesarean Section On Infants' Neurological And Mental Development

Objectives To examine the effect of elective cesarean section (ECS) on intelligence, movement development, types of temperament, neurological reflexes and general movements in infants. To evaluate the influencing factors for ECS and the psychosocial reasons for voluntary cesarean section, and seek the measures to decrease the incidence of cesarean section.Methods The infants made physical examinations periodically in three maternal and child healthcare stations in Hefei and their parents were chosen as objects. In a retrospective cohort design infants delivered by ECS (group C) and infants delivered by spontaneous delivery group (group S) were determined by self-administered questionnaires and referring to pregnant women and neonates health manuals.By use of Bayley Scales of Infant Development (BSID) and Revision of Infant Temperament Questionnaire (RITQ), mental development index (MDI), psychomotor development index (PDI) and types of temperament of 81 infants in group C and 101 in group S (182 in total) aged 8 to 12 months were assessed. By analysis of covariance the differences of MDI and PDI between the two groups were compared. The correlation between delivery modes and types of temperament was analyzed by multi-variables non-conditional logistic regression model.One hundred and five infants in group C and 163 in group S (268 in total) aged 42 days and 95 infants in group C and 150 in group S (245 in total) aged 3 months wereexamined on 8 items of primitive reflexes (PRs) and 5 items of postural reactions (PRs). In addition. 61 infants in group C and 67 in group S (128 in total) aged 3 months were kinescoped and analyzed on general movements (GMs). We respectively compared the scores of primitive reflexes and postural reactions, and the qualitative differences of postural reactions and general movements of infants under two different delivery modes in different ages.By self-administered questionnaires, the social demographic characteristics and information about pregnancy of 282 women and their infants in group C and 446 in group S were retrospectively surveyed. In addition, the reasons for voluntary cesarean section were investigated. By using multi-variables non-conditional logistic regression model, the influencing factors for ECS were analyzed. We also analyzed the proportion of reasons for voluntary cesarean section.Results After covariance adjusted for father s age at procreation, educational level of mother, monthly family incomes and birth weight of infant, MDI of group S was higher than that of group C, but there was no statistical difference between them, while PDI of group S was significantly higher than that of group C. Most of infants either in group C or in group S characterized easy and moderate types of temperament, which coincided with the regulation of temperament distribution. There was no statistical correlation between delivery modes and types of temperament.There were no statistical differences in scores of primitive reflexes and postural reactions between two groups aged 42 days and 3 months. The prevalence of abnormal postural reactions of infants aged 42 days in group C was significantly higher than that in group S, which wasn t observed in infants aged 3 months. Every infant with abnormal postural reactions had only one abnormal item. No abnormal general movements were observed in all infants.Parents ages at procreation and educational levels, monthly family incomes and...