Birth by caesarean section and school performance in Swedish adolescents- a population-based study

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dc.contributor.authorCurran, Eileen A.
dc.contributor.authorKenny, Louise C.
dc.contributor.authorDalman, Christina
dc.contributor.authorKearney, Patricia M.
dc.contributor.authorCryan, John F.
dc.contributor.authorDinan, Timothy G.
dc.contributor.authorKhashan, Ali S.
dc.contributor.funderScience Foundation Irelanden
dc.contributor.funderHealth Research Boarden
dc.contributor.funderBrain and Behavior Research Foundationen
dc.contributor.funderEuropean Commissionen
dc.contributor.funderSeventh Framework Programmeen
dc.date.accessioned2017-05-04T15:07:42Z
dc.date.available2017-05-04T15:07:42Z
dc.date.issued2017-04-17
dc.date.updated2017-05-04T14:49:52Z
dc.description.abstractBackground: Our objective was to assess the impact of obstetric mode of delivery, and in particular birth by Caesarean section (CS), on school performance in adolescents using a large, population-based cohort. Methods: We extracted data from the Swedish Medical Birth Register and National School Register. We included all live singleton births in Sweden from 1982–1995 (n = 1,489,925). School grades were reported on a scale from 0 to 320, scores less than 160 (i.e. “pass”) were considered to be “poor school performance.” Mode of delivery was categorised as: unassisted vaginal delivery (VD), assisted VD, elective CS and emergency CS. We measured the association between mode of delivery and “poor school performance” using logistic regression. We then used quantile regression to assess the association between mode of delivery and school performance across the distribution of scores. We adjusted for maternal age, parity, small and large for gestational age, gestational age, maternal country of birth, maternal depression, non-affective disorder or bipolar disorder, parental income at time of birth, and parental social welfare at time of birth. We also conducted sensitivity analyses to investigate the association further. Results: With logistic regression analysis, the adjusted odds ratio (aOR) of assisted VD and poor school performance, compared to unassisted VD, was 1.06 (95% CI: 1.03–1.08). For elective CS it was 1.06 (95% CI:1.03-1.09) and for emergency CS it was 1.12 (95% CI: 1.09–1.15). With quantile regression, assisted VD showed little difference in scores, when compared to unassisted VD, at any point across the distribution. Elective CS was associated with a 1–3 point decrease in scores, and emergency CS was associated with a 2–5 point decrease in scores. Conclusion: A slight association was found between birth by CS and school performance. However, the effect was quite small and given the complex nature of the relationship, should be interpreted with caution.en
dc.description.sponsorshipScience Foundation Ireland (SFI funded centre: The Irish Centre for Fetal and Neonatal Translational Research (INFANT) Grant number 12|RC|2272, SFI funded centre: Alimentary Pharmabiotic Centre (APC), (grant number SFI/12/RC/2273)); Health Research Board (HRB Health Research Awards (grants no HRA_POR/2011/23 and HRA_POR/2012/32); Brain and Behavior Research Foundation (NARSAD Young Investigator Grant, Grant Number 20771); European Commission (European Community's Seventh Framework Programme (MyNewGut, FFP7-KBBE/2013–2018, grant agreement no 613979).en
dc.description.statusPeer revieweden
dc.description.versionPublished Versionen
dc.format.mimetypeapplication/pdfen
dc.identifier.citationCurran, E. A., Kenny, L. C., Dalman, C., Kearney, P. M., Cryan, J. F., Dinan, T. G. and Khashan, A. S. (2017) 'Birth by caesarean section and school performance in Swedish adolescents- a population-based study', BMC Pregnancy and Childbirth, 17(1), pp. 121. doi:10.1186/s12884-017-1304-xen
dc.identifier.doi10.1186/s12884-017-1304-x
dc.identifier.endpage121-10en
dc.identifier.issn1471-2393
dc.identifier.issued1en
dc.identifier.journaltitleBMC Pregnancy And Childbirthen
dc.identifier.startpage121-1en
dc.identifier.urihttps://hdl.handle.net/10468/3919
dc.identifier.volume17en
dc.language.isoenen
dc.publisherBioMed Centralen
dc.relation.projectinfo:eu-repo/grantAgreement/EC/FP7::SP1::KBBE/613979/EU/Microbiome Influence on Energy balance and Brain Development-Function Put into Action to Tackle Diet-related Diseases and Behavior./MYNEWGUTen
dc.rights© The Authors. 2017 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.en
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/en
dc.subjectCaesarean sectionen
dc.subjectSchool performanceen
dc.subjectCohort studyen
dc.subjectQuantile regressionen
dc.titleBirth by caesarean section and school performance in Swedish adolescents- a population-based studyen
dc.typeArticle (peer-reviewed)en
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