The Effects of Cesarean Section due to Social Factors on Children’s Attention Deficit Hyperactivity Disorder and Developmental Dyslexia

The global prevalence of cesarean delivery has shown a marked upward trajectory in recent decades, with non-medically indicated cesarean section (CSs) demonstrating particularly rapid growth. Current evidence indicates potential associations between delivery methods and childhood behavioral patterns, though comprehensive studies specifically examining elective cesarean section (ECS) in relation to attention-deficit/hyperactivity (ADHD) disorder symptomatology and reading competence acquisition remain notably scarce. This study aimed to systematically evaluate the relationship between ECS and neurobehavioral characteristics in children, with particular focus on two critical dimensions: attentional functioning and reading competence. This retrospective cohort study assessed neurodevelopmental outcomes in 4,986 children aged 7-15 years using standardized scales [(Swanson, Nolan, and Pelham Questionnaire, Fourth Version (SNAP-IV) for core ADHD symptoms and Dyslexia Checklist for Chinese Children (DCCC) for dyslexia screening)]. Primary caregivers retrospectively reported delivery modes (vaginal delivery (VD), medically indicated CS, or ECS). Statistical analyses included one-way ANOVA for between-group comparisons of ADHD symptom scores (GraphPad Prism 9.0) and chi-square tests for dyslexia prevalence rates (SPSS 27.0). The study revealed that children delivered via ECS exhibited significantly more pronounced symptoms of inattention and hyperactivity/impulsivity compared to both VD and medically indicated CS groups. In reading assessment, the ECS group demonstrated a substantially higher detection rate of dyslexia, while the medically indicated cesarean group showed intermediate prevalence. All between-group differences reached statistical significance. The results suggest a potential correlation between elective cesarean delivery and children's attentional functioning and reading development. These findings offer preliminary evidence regarding the possible influence of delivery modes on child development.