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

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.