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Long term outcomes following caesarean section

Principal investigator
Neora Alterman (NPEU)
Maria Quigley (NPEU)
Child health and development
Nuffield Department of Population Health Scholarship
Start year
End year
NPEU Contact
Maria Quigley



Caesarean delivery rates in many countries are significantly higher than the WHO's recommended rate of 15%. This leads to an estimate of 6.2 million apparently unnecessary caesareans performed annually. Despite this substantial number, not enough is known in terms of the long term effect of caesarean delivery on child health, and very little has been explored as to the possible impact on the risk of infection and the psychological development of the child in terms of cognition, behaviour maternal-attachment and neurodevelopmental disorders.

Aims and objectives

The aim of the study is to examine whether mode of delivery, with emphasis on caesarean section with and without labour, is a risk factor for poorer child outcomes such as infection and impaired psychological development of the child. For infection, we will explore the mediating role of breastfeeding. For cognitive and behavioural/emotional development, we will explore time trends from infancy to age 11 and potential causative pathways.


Child outcomes will be assessed using available datasets such as the UK Millennium Cohort Study (MCS). Children born following caesarean section (planned or emergency) will be compared with those born following vaginal delivery. The MCS has data on hospitalisation for infection. Data are also available on child cognitive and behavioural outcomes.


Journal Articles