Children’s emotional and behavioural problems may be linked to a stressful birth, researchers have reported.
The Chinese research suggests, controversially, that Caesarean delivery, can help avert the impact of stress on a new-born baby.
Researchers found that assisted delivery, with instruments such as the forceps, increased stress and later problems compared with Caesarean delivery.
The researchers from Peking University Health Science Centre, Beijing, gave the 1991 Child Behaviour Checklist to parents of 4,190 preschool children. It measures aggression, hyperactivity, bullying, conduct problems, defiance, and violence.
They found greater problems – defined as ‘psychopathology’ – among children born by assisted vaginal delivery (forceps or vacuum extraction) than those born by normal vaginal delivery or caesarean chosen by the mother.
Findings are published in BJOG: An International Journal of Obstetrics and Gynaecology. Professor Jianmeng Liu and colleagues believe the link is due to raised levels of the "stress hormone" cortisol. Levels have been found to be high in babies born by assisted vaginal delivery.
Professor Liu said: "This is the first time research has looked at the effect of caesarean delivery on maternal request on childhood psychopathology. The caesarean section rate is increasing and this study was a large population based study.
"Cortisol levels have been linked to childhood psychopathology, however, more studies are still needed to look at this in more detail."
Journal editor, Professor Philip Steer, added: "With the rising rates of elective caesarean section in China and in other countries, it is interesting to see from this research that there is a low impact on childhood psychopathology.
"Assisted vaginal delivery can be more traumatic for both the mother and child hence the rise in cortisol levels. More research is needed however to look at the specific link between assisted delivery such as forceps and psychopathology in children."
Li H-T, et al. Caesarean delivery on maternal request and childhood psychopathology: a retrospective cohort study in China. BJOG, published online November 3, 2010.
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