Association between cesarean anesthesia type and long-term neurodevelopmental outcomes in offspring: a nationwide retrospective cohort study
Main finding · LNDDs (matched cohort)Result — go to the resultHazard ratio 0.87 95% CI 0.84–0.90Authors' conclusion
In this nationwide cohort, NA for cesarean delivery was associated with a modestly lower incidence and hazard of LNDDs compared with GA.
Study context
- Population
- Children born via cesarean delivery in South Korea, 2010–2014 (National Health Insurance Service data)273,266 matched
- Participants
- 735,280 children
- Exposure
- Neuraxial vs general anesthesia for cesarean delivery
- Outcome
- Diagnosis of long-term neurodevelopmental disorders (LNDDs), incl. intellectual disabilities and psychological development disorders
- Follow-up
- Through December 31, 2023
Methodological detailsnationwide, population-based, 1:1 propensity-score matched, within-family (discordant sibling) sensitivity analysis
- Nationwide
- Population-based
- 1:1 propensity-score matched
- Within-family (discordant sibling) sensitivity analysis
Main finding
LNDDs (matched cohort)
Hazard ratio
0.87
95% CI 0.84–0.90
P < 0.001
By group
NA vs GA
HR 0.87 (95% CI 0.84–0.90); P < 0.001
As reported in the abstract
Observational data: associations, not effects.
Further findings
| Outcome | HR (95% CI) | P value | |
|---|---|---|---|
| Intellectual disabilities | 0.83 (0.78–0.88) | P < 0.001 | |
| Psychological development disorders | 0.88 (0.85–0.91) | P < 0.001 | |
| 0.512Hazard ratio (log scale) |
Full cohort and sibling comparison (sensitivity analyses)
- Associations remained consistent in both the full cohort analyses and the sibling comparison
Original publication
Association between cesarean anesthesia type and long-term neurodevelopmental outcomes in offspring: a nationwide retrospective cohort study. Reg Anesth Pain Med. Published 31 December 2025. doi:10.
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