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Researchers who write in the JAMA Network Open have discovered a connection between childbirth style and some neurodevelopmental and psychiatric disorders – but the results must be taken with a grain of salt, say scientists not involved in the study. study.
The authors of the study came to the conclusion that cesarean births are associated with a low but statistically significant risk of autism and attention deficit hyperactivity disorder, or ADHD (increased likelihood of 33% and 17% respectively), after comparing the results of 61 studies conducted on 19-20 million deliveries since 1999.
But – and it's a big one – this association was not consistent among all studies. Moreover, as the authors themselves point out, there may be a third factor (or confounding factor) that explains both Caesarean section and the prevalence of both conditions, which should be examined in subsequent studies.
Of the 29 study populations used to compare autism rates among vaginal and cesarean births, 17 had an increased risk that was considered statistically significant. It was the same for five of the 14 analyzed for ADHD – these five being the largest of 14 studies, the authors say that they had more weight.
Taken together, these studies seem to suggest that having a caesarean section increases the child's risk of autism by 33% and ADHD by 17%. Since the rates for these two conditions are relatively low initially (1 to 2% for autism and 5% or more for ADHD), the implications are comparatively low.
"Overall, the disorders studied were generally rare, so even though the increases in risk are actually caused by cesarean deliveries, the absolute increases in risk are small," said Kevin McConway, professor emeritus of applied statistics at the US. Open University, UK. , who was not involved in the study, said in a statement.
"For ASDs, studies indicate that about 7 in 1,000 babies were diagnosed with ASD if they gave birth vaginally and that this rate could be 9 or 10 per 1,000 caesarean deliveries.
"ADHD was a little more common, with about 20 or 25 diagnoses per 1,000 vaginal deliveries, which would be about 25 or 30 per 1,000 caesarean deliveries."
But if the results reveal an interesting positive correlation between the two conditions (an inability to reproduce any of the other disorders examined, including intellectual disabilities, obsessive-compulsive disorders and various eating disorders), they do not show effect causal. Instead, it is more likely that there is a third factor.
Caesareans are not performed at random but for medical reasons – and doctors insist that caesareans are safe (sometimes life-saving procedures) as long as they are performed by a qualified professional.
"It is important to note that the results do not suggest that Caesarean section is at the origin of neurodevelopmental disorders.In fact, studies on siblings show that there is no causal link between caesarean section and autism, "said James Findon, a senior lecturer in psychology at King's College. London who did not participate in the study, said in a statement.
"It is possible that the association comes from a genetic or environmental factor common to neurodevelopmental disorders and the need for cesarean delivery." Parents need to be reassured about the fact that caesareans are a largely safe procedure when medically indicated. "
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