Health care consequences of cesarean birth during the first 18 months of life

OBJECTIVE: Elective cesarean delivery is increasingly common. The potential effects of surgical delivery in an unselected sample of infants beyond the immediate neonatal period remain poorly defined. METHODS: We carried out an 18-month follow-up of a population-based cohort of 8327 Hong Kong Chinese infants born in 1997. The main outcome measures were utilization of outpatient visits and hospitalizations, categorized by doctor-diagnosed causes as reported by parents. RESULTS: Among term singleton infants, there was no association of cesarean (compared with vaginal) birth with subsequent hospital admission (adjusted odds ratio = 0.92; 95% confidence interval = 0.79-1.08) or with above versus below the median number of outpatient episodes (1.10; 0.96-1.26) in the first 18 months of life. There were weak positive associations with afebrile gastrointestinal, respiratory, skin and a few other conditions. CONCLUSION: Cesarean birth is not associated with hospitalization or outpatient care overall during the first 18 months after adjustment for confounders. We cannot rule out isolated associations with minor morbidities.