Does cesarean delivery prevent cerebral palsy or other neurologic problems of childhood?
OBJECTIVE: To determine whether cesarean delivery can lead to fewer childhood neurologic problems. DATA SOURCES: We reviewed English language articles published between 1969 and 1993, obtained via MEDLINE search of the heading “delivery, abdominal.” Bibliographies of book chapters and articles about cerebral palsy and other childhood neurologic disorders were also searched. METHODS OF STUDY SELECTION: We sought articles that dealt with vaginal versus cesarean delivery and the following outcomes: cerebral palsy, abnormal neurologic development, neonatal seizures, and neonatal intraventricular hemorrhage. Ten relevant studies were identified, only four of which were prospective, and only one of which (involving breech births) was a randomized trial. DATA EXTRACTION AND SYNTHESIS: No study found a significant difference in the rates of cerebral palsy, abnormal neurologic development, and neonatal seizures between those children born vaginally or by cesarean. The severity of handicap of in