Effect of mode of birth on development of mental disorders in the offspring

Anna Skovgaard Lerche; Rune Haubo Christensen; Ole Köhler-Forsberg; Merete Nordentoft; Liselotte Vogdrup Petersen; Preben Bo Mortensen; Michael Eriksen Benros

doi:10.1017/neu.2022.27

Effect of mode of birth on development of mental disorders in the offspring

Anna Skovgaard Lerche, Rune Haubo Christensen, Ole Köhler-Forsberg, Merete Nordentoft, Liselotte Vogdrup Petersen, Preben Bo Mortensen, Michael Eriksen Benros

Publikation: Bidrag til tidsskrift/Konferencebidrag i tidsskrift /Bidrag til avis › Tidsskriftartikel › Forskning › peer review

Abstract

OBJECTIVE: Increasing rates of caesarean sections has led to concerns about long-term effects on the offspring's health, and it has been hypothesised that caesarean section induced differences in the child's microbiota could potentially increase the risk of mental disorders.

METHODS: Nationwide Danish cohort study of 2,196,687 births was conducted between 1980 and 2015, with 38.5 million observation-years. Exposure was 'Caesarean Section' and outcome was the child's risk of any mental disorder. Absolute and relative risks (RRs) were estimated using inverse probability weighting to adjust for age, calendar time and confounding variables while accounting for the competing risk of death.

RESULTS: Caesarean section (n = 364,908, 16.6%), compared to vaginal birth, was associated with a small RR increase of 8% (RR, 1.08; 95% CI, 1.04-1.13; n = 44,352) for the development of any in-patient psychiatric admission at age 36 for the offspring and with a small absolute risk difference of 0.47% (95% CI, 0.23-0.76). When looking at all in-patient, out-patient and emergency room psychiatric contacts among people born after 1995, the effect was diminished (RR, 1.04; 95% CI, 0.99-1.09; n = 15,211). The risk was comparable when comparing prelabour versus intrapartum caesarean section (RR, 0.98; 95% CI, 0.90-1.08) and acute versus planned caesarean section (RR, 1.00; 95% CI, 0.80-1.29).

CONCLUSION: Birth by caesarean section was associated with only a very slightly increased risk of any in-patient psychiatric admission for the offspring and diminished even further when including all psychiatric contacts. The very small associations observed may be explained by unmeasured confounding and is unlikely to be of substantial clinical relevance.

Originalsprog	Engelsk
Tidsskrift	Acta Neuropsychiatrica
Vol/bind	35
Nummer	2
Sider (fra-til)	88-95
Antal sider	8
ISSN	0924-2708
DOI	https://doi.org/10.1017/neu.2022.27
Status	Udgivet - apr. 2023

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10.1017/neu.2022.27

Citationsformater

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title = "Effect of mode of birth on development of mental disorders in the offspring",

abstract = "OBJECTIVE: Increasing rates of caesarean sections has led to concerns about long-term effects on the offspring's health, and it has been hypothesised that caesarean section induced differences in the child's microbiota could potentially increase the risk of mental disorders.METHODS: Nationwide Danish cohort study of 2,196,687 births was conducted between 1980 and 2015, with 38.5 million observation-years. Exposure was 'Caesarean Section' and outcome was the child's risk of any mental disorder. Absolute and relative risks (RRs) were estimated using inverse probability weighting to adjust for age, calendar time and confounding variables while accounting for the competing risk of death.RESULTS: Caesarean section (n = 364,908, 16.6%), compared to vaginal birth, was associated with a small RR increase of 8% (RR, 1.08; 95% CI, 1.04-1.13; n = 44,352) for the development of any in-patient psychiatric admission at age 36 for the offspring and with a small absolute risk difference of 0.47% (95% CI, 0.23-0.76). When looking at all in-patient, out-patient and emergency room psychiatric contacts among people born after 1995, the effect was diminished (RR, 1.04; 95% CI, 0.99-1.09; n = 15,211). The risk was comparable when comparing prelabour versus intrapartum caesarean section (RR, 0.98; 95% CI, 0.90-1.08) and acute versus planned caesarean section (RR, 1.00; 95% CI, 0.80-1.29).CONCLUSION: Birth by caesarean section was associated with only a very slightly increased risk of any in-patient psychiatric admission for the offspring and diminished even further when including all psychiatric contacts. The very small associations observed may be explained by unmeasured confounding and is unlikely to be of substantial clinical relevance.",

keywords = "Adult, Child, Female, Humans, Pregnancy, Cesarean Section/adverse effects, Cohort Studies, Mental Disorders/epidemiology, Delivery, Obstetric",

author = "Lerche, {Anna Skovgaard} and Christensen, {Rune Haubo} and Ole K{\"o}hler-Forsberg and Merete Nordentoft and Petersen, {Liselotte Vogdrup} and Mortensen, {Preben Bo} and Benros, {Michael Eriksen}",

year = "2023",

month = apr,

doi = "10.1017/neu.2022.27",

language = "English",

volume = "35",

pages = "88--95",

journal = "Acta Neuropsychiatrica",

issn = "0924-2708",

publisher = "Cambridge University Press",

number = "2",

}

TY - JOUR

T1 - Effect of mode of birth on development of mental disorders in the offspring

AU - Lerche, Anna Skovgaard

AU - Christensen, Rune Haubo

AU - Köhler-Forsberg, Ole

AU - Nordentoft, Merete

AU - Petersen, Liselotte Vogdrup

AU - Mortensen, Preben Bo

AU - Benros, Michael Eriksen

PY - 2023/4

Y1 - 2023/4

N2 - OBJECTIVE: Increasing rates of caesarean sections has led to concerns about long-term effects on the offspring's health, and it has been hypothesised that caesarean section induced differences in the child's microbiota could potentially increase the risk of mental disorders.METHODS: Nationwide Danish cohort study of 2,196,687 births was conducted between 1980 and 2015, with 38.5 million observation-years. Exposure was 'Caesarean Section' and outcome was the child's risk of any mental disorder. Absolute and relative risks (RRs) were estimated using inverse probability weighting to adjust for age, calendar time and confounding variables while accounting for the competing risk of death.RESULTS: Caesarean section (n = 364,908, 16.6%), compared to vaginal birth, was associated with a small RR increase of 8% (RR, 1.08; 95% CI, 1.04-1.13; n = 44,352) for the development of any in-patient psychiatric admission at age 36 for the offspring and with a small absolute risk difference of 0.47% (95% CI, 0.23-0.76). When looking at all in-patient, out-patient and emergency room psychiatric contacts among people born after 1995, the effect was diminished (RR, 1.04; 95% CI, 0.99-1.09; n = 15,211). The risk was comparable when comparing prelabour versus intrapartum caesarean section (RR, 0.98; 95% CI, 0.90-1.08) and acute versus planned caesarean section (RR, 1.00; 95% CI, 0.80-1.29).CONCLUSION: Birth by caesarean section was associated with only a very slightly increased risk of any in-patient psychiatric admission for the offspring and diminished even further when including all psychiatric contacts. The very small associations observed may be explained by unmeasured confounding and is unlikely to be of substantial clinical relevance.

AB - OBJECTIVE: Increasing rates of caesarean sections has led to concerns about long-term effects on the offspring's health, and it has been hypothesised that caesarean section induced differences in the child's microbiota could potentially increase the risk of mental disorders.METHODS: Nationwide Danish cohort study of 2,196,687 births was conducted between 1980 and 2015, with 38.5 million observation-years. Exposure was 'Caesarean Section' and outcome was the child's risk of any mental disorder. Absolute and relative risks (RRs) were estimated using inverse probability weighting to adjust for age, calendar time and confounding variables while accounting for the competing risk of death.RESULTS: Caesarean section (n = 364,908, 16.6%), compared to vaginal birth, was associated with a small RR increase of 8% (RR, 1.08; 95% CI, 1.04-1.13; n = 44,352) for the development of any in-patient psychiatric admission at age 36 for the offspring and with a small absolute risk difference of 0.47% (95% CI, 0.23-0.76). When looking at all in-patient, out-patient and emergency room psychiatric contacts among people born after 1995, the effect was diminished (RR, 1.04; 95% CI, 0.99-1.09; n = 15,211). The risk was comparable when comparing prelabour versus intrapartum caesarean section (RR, 0.98; 95% CI, 0.90-1.08) and acute versus planned caesarean section (RR, 1.00; 95% CI, 0.80-1.29).CONCLUSION: Birth by caesarean section was associated with only a very slightly increased risk of any in-patient psychiatric admission for the offspring and diminished even further when including all psychiatric contacts. The very small associations observed may be explained by unmeasured confounding and is unlikely to be of substantial clinical relevance.

KW - Adult

KW - Child

KW - Female

KW - Humans

KW - Pregnancy

KW - Cesarean Section/adverse effects

KW - Cohort Studies

KW - Mental Disorders/epidemiology

KW - Delivery, Obstetric

U2 - 10.1017/neu.2022.27

DO - 10.1017/neu.2022.27

M3 - Journal article

C2 - 36751902

SN - 0924-2708

VL - 35

SP - 88

EP - 95

JO - Acta Neuropsychiatrica

JF - Acta Neuropsychiatrica

IS - 2

ER -

Effect of mode of birth on development of mental disorders in the offspring

Abstract

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