分娩方式與孕期運動對兒童發展功能之影響

Examining the Associations between Mode of Delivery and Physical Activity During Pregnancy on Infant Developmental Delay

王亦苓(Florence Elaine Wong)

指導教授 ： 陳保中

國立臺灣大學/公共衛生學院/全球衛生碩士/博士學位學程/碩士(2021年)

https://doi.org/10.6342/NTU202103584

摘要

無資料

關鍵字

兒童發展 ； 剖腹產 ； 陰道分娩 ； 孕期運動

並列摘要

Background: Cesarean section (CS) delivery is a surgical procedure that can have lifesaving effects on both mother and child. However, there is inconsistent evidence showing either motor developmental and neurodevelopmental benefits associated with cesarean section. In recent decades, Taiwan has recorded some of the highest cesarean delivery rates in the world. Additionally, it is common to see a decrease or elimination of physical activity during pregnancy, due to various personal, environmental, and cultural reasons. Research suggests physical activity is associated with improved infant motor development, and can reduce the risks for medically inclined cesarean sections. There is a lack of research regarding the association between mode of delivery and physical activity during pregnancy, and developmental outcomes in children.
Objectives: This study aims to look at the relationships between mode of delivery, physical activity during pregnancy, and child developmental outcomes among children in Taiwan from birth to eighteen months.
Methods: The study population was selected from the Taiwan Birth Cohort Study. Infants’ development and exposure conditions were assessed through at-home interviews with standardized questionaries at six and eighteen months of age. Logistic regressions, multivariable logistic regressions, and the Cox proportional hazard model were performed to assess the possibility of neurodevelopmental delay associated with mode of delivery and physical activity during pregnancy.
Results: In the present study, 19,458 mother-infant cases were included in the analysis, with 12,912 mothers in the vaginal delivery (VD) group, of which 8,368 mothers did not report PA during pregnancy, while 4,544 did report PA during pregnancy. Among the 6,636 mothers that went underwent CS, 4,700 mothers did not report PA during pregnancy, while 193 mothers did report PA during pregnancy. After controlling for infant, maternal, and household factors, infants birthed through mothers that underwent vaginal delivery and physical activity during pregnancy showcased the most reduced risk for developmental delay among the eight recorded milestones.
Conclusions: This study shows overall benefits to childhood motor development among mothers that underwent vaginal delivery and performed physical activity during pregnancy. Possible developmental delays are observed among infants that were birthed through mothers that underwent cesarean section and that did not perform physical activity during pregnancy. The results of this study can posit encouragement for physical activity during pregnancy and encourage mothers to undergo vaginal delivery.

並列關鍵字

birth cohort ； infant motor development ； cesarean section ； vaginal delivery ； physical activity during pregnancy

參考文獻

Ahlberg, Mia, and Cecilia Ekeus. Birth by Vacuum Extraction Delivery and School Performance at 16 Years of Age. American Journal of Obstetrics and Gynecology, 13 Nov. 2013, https://www.ajog.org/article/S0002-9378(13)02014-0/pdfSummary.

Álvarez-Bueno, C. et al. Pregnancy leisure physical activity and children’s neurodevelopment: a narrative review. BJOG 125, 1235–1242 (2018).

Bäckhed, F. et al. Dynamics and stabilization of the human gut microbiome during the first year of life. Cell Host Microbe 17, 690–703 (2015).

Bentley JP, Roberts CL, Bowen JR, Martin AJ, Morris JM, Nassar N. Planned Birth Before 39 Weeks and Child Development: A Population-Based Study. Pediatrics. 2016 Dec;138(6):e20162002. doi: 10.1542/peds.2016-2002. Epub 2016 Nov 7. PMID: 27940704.

Betran, A. P., Torloni, M. R., Zhang, J. J., Gülmezoglu, A. M. (2016, April 1). WHO statement on caesarean section rates. BJOG: An International Journal of Obstetrics and Gynaecology. Blackwell Publishing Ltd. https://doi.org/10.1111/1471-0528.13526