Operative vaginal delivery and third grade educational outcomes

Ayala, Nina K.; Schlichting, Lauren E.; Kole, Martha B.; Clark, Melissa A.; Vivier, Patrick M.; Viner-Brown, Samara; Werner, Erika F.

doi:10.1016/j.ajogmf.2020.100221

Cited by 6 publications

(7 citation statements)

References 20 publications

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“…Our results are in line with other studies which showed no correlation between long-term morbidity and neurodevelopment of the children up to the age of 5 and the mode of delivery [36][37][38]. Ayala et al examined differences in later childhood educational outcomes after AVB and cesarean section by comparing children's third grade reading and math proficiencies and reported no differences [31].…”

Section: Discussionsupporting

confidence: 92%

“…Previous studies also showed higher number of male children born with forceps [30][31][32]. The average birthweight was similar to the findings from previous studies [30,31].…”

Section: Discussionsupporting

confidence: 87%

“…Two different studies examining effects of AVB reported slightly lower maternal average age than the one observed here [30,31]. The previous study has shown the same percentage for gestational hypertension, but lower percentage of 3% for gestational diabetes.…”

Section: Discussioncontrasting

confidence: 50%

“…Average AS was 7.2 in the 5th minute, while 24% of newborns had AS lower than 7. One cohort study showed that 17% of children born with AVB had 5th min AS < 7 [32], whereas another one reported average 5th min AS of 8.83 among children born with AVB [31].…”

Section: Discussionmentioning

confidence: 99%

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Neurodevelopment of Children Born with Forceps Delivery

Kostic,

Ivanovic,

Jovanovic

et al. 2024

Preprint

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Background/Objectives: Forceps delivery is a crucial obstetrical technique that has been increasingly underutilized in favor of cesarean delivery, despite numerous complications related to cesarean section. The major concerns in assisted vaginal birth (AVB) are the safety and long-term consequences. Thus, we aimed to investigate the neurodevelopmental outcome of children born with forceps delivery up to the age of seven. Methods: A prospective descriptive study was conducted from January 2011 to December 2016 among 49 women from our department in the Clinic for Gynecology and Obstetrics, University Clinical Center of Serbia. The study included women with term singleton cephalic pregnancies. Descriptive statistics were calculated for the baseline demographic and clinical features, whereas the logistic regression analysis was used to explore the association between various perinatal parameters and neurological status of newborns. The Sarnat and Sarnat classification was used to evaluate neurological status of newborns, while long-term neurodevelopmental outcome was assesed with Griffiths Mental Development Scale and additional questions based on the neurologist's clinical practice and experience. Results: Pathological neurological status of the newborn was found in 16.3%, with pathological ultrasound of CNS in 3%. A statistically significant association was observed with Apgar score, odds ratio of 0.575 (95% CI: 0.407–0.813, p = 0.002) and perinatal asphyxia, odds ratio of 9.882 (95% CI: 1.111–87.902, p = 0.04). However, this was unlikely to be related to the mode of delivery. Long-term adverse neurological outcome was seen in three cases, which accounts for 6.4%. These included mild disorders, such as delayed milestone, speech delay and motor clumsiness. Conclusion: The present study highlights the safety of forceps delivery regarding children's neurological outcomes at 7 years of age. This is an important contribution to the modern management of labor, especially in light of increasing rates of cesarean deliveries worldwide.

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Section: Discussionsupporting

confidence: 92%

“…Previous studies also showed higher number of male children born with forceps [30][31][32]. The average birthweight was similar to the findings from previous studies [30,31].…”

Section: Discussionsupporting

confidence: 87%

Section: Discussioncontrasting

confidence: 50%

Section: Discussionmentioning

confidence: 99%

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Neurodevelopment of Children Born with Forceps Delivery

Kostic,

Ivanovic,

Jovanovic

et al. 2024

Preprint

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“…Studies of mode of birth have been inconclusive. Children born via planned cesarean delivery have been reported to be at increased risk of early childhood delay when compared with “normal births.” Other studies have reported no difference in third-grade outcomes between children born via planned cesarean delivery and those born via unassisted vaginal birth . We note that none of these prior studies have focused on clinical decision-making around elective birth at 39 weeks’ gestation and the mode of elective birth at this gestation.…”

Section: Discussionmentioning

confidence: 86%

Developmental Outcomes for Children After Elective Birth at 39 Weeks’ Gestation

et al. 2022

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IMPORTANCE Elective births at 39 weeks' gestation are increasing. While this option may improve maternal and perinatal outcomes compared with expectant management, longer-term childhood developmental outcomes are uncertain.OBJECTIVE To investigate the association between elective birth at 39 weeks' gestation and the risk of childhood developmental vulnerability. DESIGN, SETTING, AND PARTICIPANTSFor this cohort study, 2 causal inference analyses were conducted using Australian statewide, population-based data. Perinatal data from births between January 1, 2005, and December 31, 2013, were linked to childhood developmental outcomes at age 4 to 6 years (assessed using multiple imputation via inverse probability-weighted regression adjustment). Data analyses were conducted between September 7 and November 9, 2021.EXPOSURES Two exposure groups were considered: (1) elective birth between 39 weeks and 0 days' and 39 weeks and 6 days' gestation vs expectant management and (2) birth via induction of labor vs planned cesarean delivery among those born electively at 39 weeks' gestation. MAIN OUTCOMES AND MEASURESChildhood developmental vulnerability at school entry, defined as scoring below the 10th percentile in at least 2 of 5 developmental domains (physical health and well-being, social competence, emotional maturity, school-based language and cognitive skills, and communication skills and general knowledge). RESULTSOf 176 236 births with linked outcome data, 88 165 met the inclusion criteria. Among these, 15 927 (18.1%) were elective births at 39 weeks' gestation (induction of labor or planned cesarean delivery), and 72 238 (81.9%) were expectantly managed with subsequent birth between 40 and 43 weeks' gestation. Compared with expectant management, elective birth at 39 weeks' gestation was not associated with an altered risk of childhood global developmental vulnerability (adjusted relative risk [aRR], 1.03; 95% CI, 0.96-1.12) or with developmental vulnerability in any of the individual domains. In an analysis restricted to elective births at 39 weeks' gestation, induction of labor (n = 7928) compared with planned cesarean delivery (n = 7999) was not associated with childhood developmental vulnerability (aRR, 0.96; 95% CI, 0.82-1.12) or with vulnerability in any individual domains. CONCLUSIONS AND RELEVANCEIn this cohort study, elective birth at 39 weeks' gestation was not associated with childhood developmental vulnerability. For those born electively at 39 weeks' gestation, birth after induction of labor or by elective cesarean delivery had similar developmental outcomes.

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