Long-Term Neurodevelopmental Outcomes After Forceps, Vacuum, and Second-Stage Cesarean Delivery

Is there an association between mode of delivery in the second stage of labor and attention-deficit/hyperactivity disorder (ADHD), autism spectrum disorder (ASD), and intellectual disability (ID)?This cohort study of 504 380 children found higher rates of ADHD among children who underwent sequential instrument delivery compared with second-stage cesarean delivery, higher rates of ID among those who underwent vacuum delivery, and similar rates of ASD between mode of delivery groups.The findings of this study suggest that operative vaginal delivery and second-stage cesarean delivery have comparable neurodevelopmental outcomes among offspring, except among those who underwent sequential instrument and vacuum delivery, which were associated with ADHD and ID, respectively.

Corresponding Author: Maya Rajasingham, MPH, Department of Obstetrics and Gynecology, Faculty of Health Sciences, McMaster University, MPH, HSC3V-43B, 1200 Main St W, Hamilton, ON L8N 3X5, Canada (rajasinm@mcmaster.ca).

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