Figure 2. Risk of Neurodevelopmental Disorders (NDD) Among Individuals Delivered by Planned and Intrapartum Cesarean Delivery (CD), Compared With Vaginally Delivered Individuals.

Hazard ratios (HRs) with 95% CIs are presented with 3 levels of adjustments for each outcome for planned CD (A) and intrapartum CD (B). The outcomes were any neurodevelopmental disorder, including attention-deficit/hyperactivity disorder (ADHD), autism spectrum disorders (ASD), intellectual disability, tic disorders, communication disorders, and learning disorders. Model 1 (orange) adjusted for child’s sex and year of birth. Model 2 (light blue) adjusted for child’s sex and year of birth, gestational age, age of mother and father at birth, parity, mother’s highest education level at birth, maternal smoking during pregnancy, and maternal and paternal history of psychiatric disorders. In addition to variables adjusted in Model 2, Model 3 (dark blue) further adjusted for maternal hypertension, maternal diabetes, maternal infections during pregnancy, fetal malpresentation, large for gestational age, polyhydramnios, oligohydramnios, and preeclampsia. Model 3 included data from panels A and B. For planned CD, we further adjusted for pelvic disproportion. For intrapartum CD, we further adjusted for pelvic disproportion, placenta disorders, dystocia, failed induction, and fetal distress.