the impact of delivery mode on the development of behavioral disorders in children

Background: existing evidence on the relationship between mode of delivery and offspring’s emotional and behavioral problems is limited and inconsistent.objectives: this study investigated the relationship between anesthesia during childbirth and behavioral disorders in children.materials & methods: this research was conducted at psychiatric clinics affiliated with guilan university of medical sciences (gums), rasht city, iran. the studied population consisted of children who were diagnosed with autism spectrum disorder, attention-deficit/hyperactivity disorder, and oppositional defiant disorder based on dsm-5 criteria. for each case, a healthy sibling was considered as a control group. we completed a checklist containing the type of delivery, including normal vaginal delivery (nvd), cesarean section (cs) under general anesthesia (ga) or spinal anesthesia (sa), and painless labor, as well as neonate birth status (term/preterm).results: in this study, 720 children aged 4-18 were enrolled. no significant difference was observed in terms of birth status (term or preterm) (p=0.482), age (p=0.464), and mode of delivery (p=0.236), while the difference was significant regarding gender (p=0.001) and type of anesthesia (p=0.0001). so, delivery under ga was significantly associated with behavioral disorders compared to nvd or cs under sa (p=0.0001). the logistic regression test demonstrated that cs under ga increases 2.74 times the likelihood of later development of behavioral disorders.conclusion: children born by elective cs under ga may face childhood behavioral problems. further investigation is needed to support these findings in other populations and explore the potential biological mechanisms.