Long-term neurodevelopmental outcome in children born after vacuum-assisted delivery compared with second-stage caesarean delivery and spontaneous vaginal delivery: a cohort study
Objective To evaluate long-term neurodevelopment in children born after low-or mid-station vacuum-assisted delivery (VAD) compared with children delivered by second-stage caesarean delivery (SSCD) or spontaneous vaginal delivery (SVD).Design Cross-sectional cohort study.Setting Two delivery wards, K...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2023-10-01
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| Series: | BMJ Paediatrics Open |
| Online Access: | https://bmjpaedsopen.bmj.com/content/7/1/e002048.full |
| _version_ | 1797311655741227008 |
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| author | Magnus Westgren Katarina Lindström Stefhanie Romero Johanna Listermar Gunilla Ajne |
| author_facet | Magnus Westgren Katarina Lindström Stefhanie Romero Johanna Listermar Gunilla Ajne |
| author_sort | Magnus Westgren |
| collection | DOAJ |
| description | Objective To evaluate long-term neurodevelopment in children born after low-or mid-station vacuum-assisted delivery (VAD) compared with children delivered by second-stage caesarean delivery (SSCD) or spontaneous vaginal delivery (SVD).Design Cross-sectional cohort study.Setting Two delivery wards, Karolinska University Hospital, Sweden.Patients 253 children born by low-station or mid-station VAD, 247 children born after an SVD, and 86 children born via an SSCD accepted to participate.Interventions The Five-to-Fifteen questionnaire was used as a validated screening method for neurodevelopmental difficulties, assessed by parents.Main outcomes measures Results in the Five-to-Fifteen questionnaire. In addition, registered neurodevelopmental ICD-10 diagnoses were collected. Regression analyses estimated associations between delivery modes.Results Children born after VAD exhibited an increased rate of long-term neurodevelopmental difficulties in motor skills (OR 2.2, 95% CI 1.3 to 3.8) and perception (OR 1.7, 95% CI 1.002 to 2.9) compared with SVD. Similar findings were seen in the group delivered with an SSCD compared with SVD (motor skills: OR 3.3, 95% CI 1.8 to 6.4 and perception: OR 2.3, 95% CI 1.2 to 4.4). The increased odds for motor skills difficulties after VAD and SSCD remained after adjusting for proposed confounding variables. There were significantly more children in the VAD group with registered neurodevelopmental ICD-10 diagnoses such as attention deficit/hyperactivity disorders.Conclusions The differences in long-term neurodevelopmental difficulties in children delivered with a VAD or SSCD compared with SVD in this study indicate the need for increased knowledge in the field to optimise the management of second stage of labour. |
| first_indexed | 2024-03-08T02:03:47Z |
| format | Article |
| id | doaj.art-81d277dac7194aea80dbf1edf9985e84 |
| institution | Directory Open Access Journal |
| issn | 2399-9772 |
| language | English |
| last_indexed | 2024-03-08T02:03:47Z |
| publishDate | 2023-10-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Paediatrics Open |
| spelling | doaj.art-81d277dac7194aea80dbf1edf9985e842024-02-14T01:55:10ZengBMJ Publishing GroupBMJ Paediatrics Open2399-97722023-10-017110.1136/bmjpo-2023-002048Long-term neurodevelopmental outcome in children born after vacuum-assisted delivery compared with second-stage caesarean delivery and spontaneous vaginal delivery: a cohort studyMagnus Westgren0Katarina Lindström1Stefhanie Romero2Johanna Listermar3Gunilla Ajne4Division of Obstetrics and Gynaecology, Karolinska Institute Department of Clinical Science Intervention and Technology, Huddinge, SwedenNeuropaediatrics, Karolinska University Hospital, Stockholm, SwedenDivision of Obstetrics and Gynaecology, Karolinska Institute Department of Clinical Science Intervention and Technology, Huddinge, SwedenKarolinska Institute, Stockholm, SwedenDivision of Obstetrics and Gynaecology, Karolinska Institute Department of Clinical Science Intervention and Technology, Huddinge, SwedenObjective To evaluate long-term neurodevelopment in children born after low-or mid-station vacuum-assisted delivery (VAD) compared with children delivered by second-stage caesarean delivery (SSCD) or spontaneous vaginal delivery (SVD).Design Cross-sectional cohort study.Setting Two delivery wards, Karolinska University Hospital, Sweden.Patients 253 children born by low-station or mid-station VAD, 247 children born after an SVD, and 86 children born via an SSCD accepted to participate.Interventions The Five-to-Fifteen questionnaire was used as a validated screening method for neurodevelopmental difficulties, assessed by parents.Main outcomes measures Results in the Five-to-Fifteen questionnaire. In addition, registered neurodevelopmental ICD-10 diagnoses were collected. Regression analyses estimated associations between delivery modes.Results Children born after VAD exhibited an increased rate of long-term neurodevelopmental difficulties in motor skills (OR 2.2, 95% CI 1.3 to 3.8) and perception (OR 1.7, 95% CI 1.002 to 2.9) compared with SVD. Similar findings were seen in the group delivered with an SSCD compared with SVD (motor skills: OR 3.3, 95% CI 1.8 to 6.4 and perception: OR 2.3, 95% CI 1.2 to 4.4). The increased odds for motor skills difficulties after VAD and SSCD remained after adjusting for proposed confounding variables. There were significantly more children in the VAD group with registered neurodevelopmental ICD-10 diagnoses such as attention deficit/hyperactivity disorders.Conclusions The differences in long-term neurodevelopmental difficulties in children delivered with a VAD or SSCD compared with SVD in this study indicate the need for increased knowledge in the field to optimise the management of second stage of labour.https://bmjpaedsopen.bmj.com/content/7/1/e002048.full |
| spellingShingle | Magnus Westgren Katarina Lindström Stefhanie Romero Johanna Listermar Gunilla Ajne Long-term neurodevelopmental outcome in children born after vacuum-assisted delivery compared with second-stage caesarean delivery and spontaneous vaginal delivery: a cohort study BMJ Paediatrics Open |
| title | Long-term neurodevelopmental outcome in children born after vacuum-assisted delivery compared with second-stage caesarean delivery and spontaneous vaginal delivery: a cohort study |
| title_full | Long-term neurodevelopmental outcome in children born after vacuum-assisted delivery compared with second-stage caesarean delivery and spontaneous vaginal delivery: a cohort study |
| title_fullStr | Long-term neurodevelopmental outcome in children born after vacuum-assisted delivery compared with second-stage caesarean delivery and spontaneous vaginal delivery: a cohort study |
| title_full_unstemmed | Long-term neurodevelopmental outcome in children born after vacuum-assisted delivery compared with second-stage caesarean delivery and spontaneous vaginal delivery: a cohort study |
| title_short | Long-term neurodevelopmental outcome in children born after vacuum-assisted delivery compared with second-stage caesarean delivery and spontaneous vaginal delivery: a cohort study |
| title_sort | long term neurodevelopmental outcome in children born after vacuum assisted delivery compared with second stage caesarean delivery and spontaneous vaginal delivery a cohort study |
| url | https://bmjpaedsopen.bmj.com/content/7/1/e002048.full |
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