Study: Children Delivered Vaginally Perform Differently at Numeracy Than Caesarean Babies

I am a doctor. And, my baby was delivered by a C-section. Heck, even I was delivered by a C-Section, so was my brother. And we are doing quite well, academically speaking! And so, when I read this news, I almost dismissed it as 'one of those studies' till I saw that it was published in the journal Nature - one of the most respected journals in the scientific communities. 

In the scientific report, it was found that children who were delivered by Caesarean section had a disadvantage - they performed a tad bit poorly than their counterparts who were delivered vaginally. 

The study

There has been an increase in the incidence of Caesarean births, something that is not accounted by the increase in risk factors. It grew from 14.4% in 1990 to 25.8% in 2009 in OECD countries. This means that 1 in every fourth birth was a Caesarean birth. And the only explanation to this is an increase in a request by the mother to perform a planned c-section. But does it have any effect on the children?

And to study exactly this, a team of scientists in Melbourne, Australia, studied 3666 children between the ages of 4 through 9. The idea was to see the impact of the type of birth on the cognitive performance of a child as he grows up. The study analysed data from the Longitudinal Study of Australian Children (LSAC). LSAC is a nationally representative birth cohort surveyed twice a year. 

The team took into account factors like gestational age, socioeconomic condition, relationship status, the age of the mother while giving birth. The scientists found that there is a correlation between inadequate breastfeeding, usually associated with but not exclusive to Caesarean births and cognitive performance of the child.

It was seen that the incidence of inadequate breastfeeding, obesity, and ADHD was higher in the children born by Caesarean section. And, there was a negative correlation with these factors with cognitive performance. However, it accounted for just 30% of correlation. This means that there are factors other than these that affect the performance of children, based on the mode of delivery.

What may cause the difference

According to the authors, the rest 70% might be explained by the gut bacteria. The composition of the gut bacteria is different for children delivered vaginally vis a vis those delivered by a Caesarean section. These bacteria are known to have a communication with the central nervous system of the child. 

As they state,

"Although causal impacts on child development are yet to be proven, altered signaling from disturbed gut microbiota is thought to be a possible driver of higher rates of cognitive disorders, especially autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD), among cesarean-born children."

What does it mean for parents

To be fair, this study does not mean that if your child was born by C-Section, he would be at a disadvantage throughout his life. It is just an indicator of how children in Australia perform at school, and if there is a linkage with the type of birth. You are in a good shape especially if you are well-educated, had a late pregnancy, and, in general, take a keen interest in the education of your child.

That said, if you are thinking of delivering a baby by a planned C-section, you need to take into account the risk factors associated with it. 

Is Caesarean section for everyone?

Objectively speaking, and based on the evidence at hand, it is suggested that a Caesarean section is to be performed only when medically indicated. Most of the Obstetricians will give the mother a trial of labour. This is because there are certain risks and concerns associated with a C-Section.

Risks and concerns

1. As this is a surgical procedure, the risks of surgery apply to the mother.
2. Many mothers find it difficult to initiate breastfeeding when they undergo a C section.
3. The lack of bacterial exposure typically seen in vaginal births may have an effect on the general health of the baby
4. The incidence of Asthma, Type I Diabetes, Allergies and obesity is slightly higher in children delivered via a C-Section

So, think carefully before you plan an elective C section. It may not be in the best interest of your child to do so. 

Also, read: Mother’s immunity might play a significant role in preterm labour and miscarriages