Babies who undergo a difficult birth and are delivered using forceps are more likely to develop problems such as aggression during childhood compared with those born by Caesarean section, according to a study in China.
The researchers believe the behavioral problems may be linked to high levels of cortisol, a hormone the body produces when under stress and during a stressful and difficult birth.
“The association between mode of delivery and subsequent childhood psychopathology is possibly related to cortisol response,” they wrote in a paper published in BJOG: An International Journal of Obstetrics and Gynaecology yesterday.
Previous studies have found that cortisol levels in cord blood are lowest in babies born by elective Caesarean, followed by spontaneous vaginal delivery.
The highest levels of cortisol are found in those born by assisted vaginal delivery using forceps or vacuum extraction.
“Cortisol levels have been linked to childhood psychopathology, however, more studies are still needed to look at this in more detail,” wrote the scientists, led by Liu Jianmeng, deputy director of the Institute of Reproductive and Child Health at the Peking University Health Science Center.
The study involved 4,190 children who were born in China’s provinces of Zhejiang and Jiangsu, and they were assessed between the age of four and six for problems such as being withdrawn, anxious, depressed, attention difficulties and delinquent and aggressive behavior.
Such problems were lowest in children delivered by Caesarean section and highest in those delivered using instruments like forceps and vacuum, the researchers said.
Caesarean births are increasing in China, particularly in the richer southeastern parts of the country where rates have risen to 56 percent in 2006 from 22 percent in 1994.
Caesarean delivery on request by mothers is a major contributor to this trend. It accounted for 3.6 percent of all Caesarean births in 1994 and 36 percent in 2006 in southeast China.
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