Relations between mode of birth delivery and timing of developmental milestones and adiposity in preadolescence: A retrospective study

Morgan R. Chojnacki, Hannah D. Holscher, Alaina R. Balbinot, Lauren B. Raine, John R. Biggan, Anne M. Walk, Arthur F. Kramer, Neal J. Cohen, Charles H. Hillman, Naiman A. Khan

Research output: Contribution to journalArticlepeer-review


Background: Cesarean delivery (CS) is an increasingly common mode of delivery comprising over 30% of all deliveries in the U.S. The long-term impact of this delivery mode on child development remains unclear. Aims: We investigated the relationship between mode of delivery (vaginal vs. CS) and timing of developmental milestones and adiposity in preadolescence, as well as additional milestones beyond motor/language development including toilet training, dressing, and feeding self. Study design: This study utilized a retrospective survey given to a parent/guardian and dual energy x-ray absorptiometry in preadolescence, respectively. A composite z-score was calculated based on nine questions pertaining to developmental milestones i.e., parent-reported age for supporting head by self, rolling over, sitting up, standing, walking, talking, toilet-training, dressing, and feeding self. Subjects: 7–10-year-old (N = 104) children in East-Central Illinois. Outcome measures: Composite z-score for timing of attainment of developmental milestones, mode of delivery, and preadolescent adiposity. Results: Vaginally-born children had a lower composite z-score, signifying earlier attainment of developmental milestones, relative to both emergency and planned CS-born children. Further, elective CS-born children had greater adiposity in preadolescence, relative to vaginal and emergency cesarean-section born children. Conclusions: These findings suggest relationships between delivery mode, developmental milestones, and obesity in preadolescence. Additionally, they provide novel insights into the differential impact of elective versus emergency CS.

Original languageEnglish (US)
Pages (from-to)52-59
Number of pages8
JournalEarly Human Development
StatePublished - Feb 2019


  • Birth method
  • Cesarean section
  • Developmental milestones
  • Gross motor development
  • Language development
  • Mode of delivery
  • Vaginal delivery

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Obstetrics and Gynecology

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