ArticlePDF Available

Method of Delivery and Developmental Outcome At Five Years of Age

Authors:
  • Secure Beginnings

Abstract

A controlled follow-up study examined the impact of delivery method on developmental outcome of the child. The modes of delivery investigated were low forceps delivery (188 infants), midcavity forceps delivery (51 infants), forceps rotation with forceps delivery (57 infants), manual rotation with forceps delivery (67 infants), elective caesarean section (101 infants) and spontaneous delivery (control, 207 infants). Breech presentation (100 infants) was separately compared with the vertex presentation groups. Sample selection controlled for complications during pregnancy and low birthweight and was restricted to married English-speaking mothers. The children were assessed at the age of five years on verbal and non-verbal subtests of a standardized intelligence scale, tests of gross motor coordination, and auditory and visual tests. A full paediatric examination was also performed. Breech presentation children performed less well on tests of balance and fine motor coordination and on visual acuity and stereopsis testing than children who presented in the vertex position. No deleterious effect of delivery method was found. In the absence of other complicating events (like a poor antenatal history, prematurity, and a disorganized home environment) delivery complication constitutes an early risk factor which the growing child is able to overcome.
... However, for older children, these differences became more pronounced, especially in the 26-to-48-months range where the greatest differences between the types of delivery were noted; the best results were found for children born via eutocic delivery in terms of both global and fine motor skills. These results are in line with those obtained by Rodrigues and Silva [32], who found that those born via cesarean section (dystocic delivery) have worse locomotion, manipulation, visual, speech and language skills and personal autonomy compared to those born through a eutocic delivery; McBride et al. [33] also concluded that children born via a dystocic delivery had worse balance performance, fine motor coordination, and visual acuity compared to those born via a eutocic delivery. There are few investigations on this variable, especially in these age groups, but even so, it is essential to mention that according to recent studies, the type of delivery is an option in 80% of cases, where the mother usually opts for a dystocic delivery (cesarean, induced, forceps, etc.); this is usually done to avoid pain and sacrifice, but according to medicine, can bring serious complications for the mother and the baby. ...
Article
Full-text available
This study aimed to verify whether the presence of siblings and the type of delivery had an influence on the motor skills development of children in the first 48 months of life. We developed a quantitative study with a sample of 405 children of both genders, divided according to the studied variables: children with siblings, children without siblings, children born via eutocic delivery, and children born via dystocic delivery. The instrument used in the study was the Peabody Developmental Motor Scales-2. Overall, the results indicated that children who had siblings had, on average, better outcomes regarding all motor skills (global and fine). Furthermore, those born via eutocic delivery, on average, had better outcomes regarding all motor skills (global and fine) when compared to children born via dystocic delivery. Thus, the presence of siblings in the family context and the type of delivery positively influenced motor development, especially after 24 months of age, showing that the presence of siblings providing cooperative activities through play and challenges improved cognitive, social, emotional, and physical development. Furthermore, a eutocic delivery, in addition to providing a better recovery from labor and the immediate affective bond between mother and child, also led to better results in terms of global and fine motor skills.
Article
Full-text available
Background: Caesarean section is associated with different development outcomes in children. In this way, the type of delivery can influence the health of the child. Objectives: To investigate the existence of differences in skill development up to the age of 2 between children who were born by vaginal delivery and those born by elective cesarean section. Methodology: Observational and cross-sectional study with a sample composed of 400 dyads, using a quantitative methodology based on a multivariate analysis with Generalized Linear Models in IBM SPSS Statistics, version 18.0. Results: Children born by cesarean delivery scored lower in the locomotor skill domain, but still within the normal parameters for their age. They also scored lower in the manipulative, visual, speech and language, and self-care skill domains than those born by vaginal delivery. No differences were found between groups in the cognitive, hearing and language, and interactive-social skills. Conclusion: Significant differences were found in the development of some skills at 2 years of age between children born by elective cesarean section and those born by normal delivery.
Chapter
Full-text available
The short- and long-term effects of obstetric anaesthetic techniques on behaviour and development of the neonate, infant and child have been of long-standing interest. It is clear that these techniques may at least transiently affect some aspects of newborn behaviour [1–7]. However, the impact of obstetric analgesia and anaesthesia on long-term outcomes in the absence of concurrent events such as foetal asphyxia is not known. Studies evaluating the association between perinatal and environmental characteristics and childhood behavioural outcomes have suggested that operative or instrumented deliveries per se are not linked to childhood behavioural disorders or abnormalities in cognitive, verbal or reading functioning [8–12], but these studies do not specifically evaluate the impact of anaesthesia and analgesia.
Article
… the Forceps…As it is not sharper than the Hand, it may be introduced with all imaginable Safety,…I can, from my own Experience, affirm it to be a most excellent Instrument, and so far from Hurting or Destroying, that it frequently saves the Mother's Life, and That of the Child, as will appear in the Course of this Treatise. Edmund Chapman (1680?–1756) Treatise on the Improvement of Midwifery Third Edition, London 1759, John Brindley: pp. xxvii–iii. ROLE OF INSTRUMENTAL DELIVERY. Since its inception in the seventeenth century, instrumental delivery has been controversial [1–5]. Although most practitioners employ methods of assisted delivery on occasion, there are substantial international and local variations, and the acceptability of certain techniques has changed rapidly in recent decades [6,7]. Although both forceps and the vacuum extractor continue in everyday use, vacuum extraction continues to gain in popularity [8–10]. In the United States, the prevalence of operative vaginal delivery is estimated at 10% to 15% [11]. Despite changes in practice and in the popularity of forceps versus vacuum extractor over recent decades, the important questions about assisted delivery remain the same: when to conduct operative deliveries, which instrument is best for specific indications, and what the associated short- and long-term risks are. Previous generations of obstetricians were taught that the principal indications for instrumental delivery were two: prevention and rescue.
Chapter
Although there is undoubtedly an association between the use of regional analgesia, length of labour and mode of delivery, the nature of this relationship is complex. Evidence is conflicting and in many studies scientific methods are unreliable. Retrospective studies are flawed because women do not choose analgesia at random whilst randomised prospective studies are not blinded, allowing observer bias. Impact studies may be more useful, although they take no account of other changes in clinical practice. Such changes, however, may be crucial, in order to maximise the spontaneous delivery rate. Whether regional analgesia prolongs labour and causes operative and instrumental deliveries is possibly of less importance than establishing the optimum management for women choosing this most effective form of pain relief. Therefore future research must encompass the variety of factors, both obstetric and anaesthetic, on which labour and delivery outcomes are dependent.
Article
Obstetric management of term breech infants changed dramatically following the Term Breech Trial which suggested increased serious neonatal morbidity following trial of labour. Short-term morbidity is a poor proxy of long-term neurological sequelae. We determined whether vaginal breech delivery was associated with educational outcomes. We linked three Scotland-wide administrative databases at an individual level: the ScotXed school census; Scottish Qualifications Authority (SQA) examination results; and Scottish Morbidity Record (SMR02) maternity database. The linkage provided information on singleton children, born at term, attending Scottish schools between 2006 and 2011. Of the 456 947 eligible children, 1574 (0.3%) had vaginal breech deliveries, 12 489 (2.7%) planned caesarean section for breech presentation and 442 090 (96.9%) vaginal cephalic deliveries. The percentage of term breech infants delivered vaginally fell from 23% to 7% among children who started school in 2006 and 2011, respectively. Of children born by vaginal breech delivery, 1.5% had a low 5-min Apgar score (≤3) compared with only 0.4% of those born by either breech caesarean section [adjusted odds ratio (OR) 6.16, 95% confidence interval (CI) 4.44-8.54, p < 0.001] or cephalic vaginal delivery (adjusted OR 3.84, 95% CI 2.99-4.93, p < 0.001). Children born by vaginal breech delivery had lower examination attainment than those born by either planned caesarean section for breech presentation (adjusted OR 1.16, 95% CI 1.02-1.32, p = 0.020) or vaginal cephalic delivery (adjusted OR 1.14, 95% CI 1.01-1.28, p = 0.029). Vaginal delivery of term breech infants was associated with lower examination attainment, as well as poorer Apgar scores, suggesting that the adverse effects are not just short-term. © The Author 2015; all rights reserved. Published by Oxford University Press on behalf of the International Epidemiological Association.
ResearchGate has not been able to resolve any references for this publication.