Relationship between type of delivery and twins’ psychological development

Summary: The delivery method of twins may play a role in their neuropsychological development. A correlation has been discovered between twins born by cesarean section and poor cognitive development compared to twins born via virginal delivery.

Source: University of Malaga

A research team of the University of Malaga (UMA) in the Medicine and Psychology departments have analyzed, for the first time, the effect of the type of delivery on twins’ psychological development and intelligence, demonstrating that cesarean section carries an independent risk in these multiple births.

“Twins are very vulnerable since their birth frequently ends prematurely and they often present pregnancy and labor complications”, says Professor of Gynecology of the UMA Ernesto González Mesa, who adds the possible difficulties that may derive from cesarean section are very common in multiple births.

“We have verified that cesarean section becomes a risk factor to development. This is why gynecologists firmly believe in vaginal delivery benefits, and we defend the use of this surgical intervention only as an option when problems arise”, says González Mesa.

The study, published in Frontiers in Psychology, comprised a total of 160 twins born in Hospital Materno-Infantil in Málaga in the year 2005; there were 7000 births in this period, and almost 300 were multiple births. From the sample of all twins, 55 percent were born by vaginal delivery and 45 percent by cesarean delivery.

In the first stage of the study, the children’s intelligence, neuropsychological and psycho-pedagogical development were tested. The results were compared in a second stage, with information on obstetric and perinatal variables, such as type of delivery, its problems, maternal age or newborn weight, among other variables.

“When comparing all data, we found out that those children that had a lower intellectual level and cognitive development were born by cesarean delivery”, explains María José González Valenzuela, Professor from the Evolutive Psychology and Education Department and main researcher of the study.

This shows newborn twins
In a first stage of the study, the children’s intelligence, neuropsychological and psychopedagogical development were tested. The image is in the public domain.

The expert asserts that, apart from early diagnosis, this study seeks intervention through activities at school and primary health care centers. In this regard, Counselor Olga Cazorla Granados, co-author of this study, adds that there is an increased tendency in educational environments to search for neurological factors to explain difficulties in psychological development.

Addressing the major reading, writing and calculating difficulties that twins often have, and identifying benefits of vaginal delivery as against cesarean section, such as the neurological effects that children’s intestinal flora differs between delivery type, this study may give rise to future lines of research.

About this neuroscience research article

University of Malaga
Media Contacts:
María Guerrero Aguilar – University of Malaga
Image Source:
The image is in the public domain.

Original Research: Open access
“Type of Delivery, Neuropsychological Development and Intelligence in Twin Births”. González-Valenzuela M-J, González-Mesa E, Cazorla-Granados O and López-Montiel D.
Frontiers in Physiology. doi:10.3389/fpsyg.2019.00972


Type of Delivery, Neuropsychological Development and Intelligence in Twin Births

Based on a retrospective cohort design with 6-year-old children born in twin births, the relationship between verbal, non-verbal, global neuropsychological development, general intelligence, and type of delivery has been studied. To this end, the possible effect of third gestational, obstetric and neonatal variables, such as maternal age at delivery, fetal presentation, gestational age, newborn weight and Apgar at minute one, was controlled. The exposed cohort includes children born by cesarean section, and the unexposed cohort is composed of children born vaginally with or without induction. A total of 124 children were evaluated in their 1st year of primary school using the Child Neuropsychological Maturity Questionnaire, Kaufman’s Intelligence Test and the medical histories of the children collected after birth. By means of binary logistic regression analysis, it has been found that the type of delivery is presented as an independent risk factor for disorders in verbal, non-verbal and global development and for the general intellectual difficulties of children born of multiple births. These results suggest the need to analyze in future prospective studies with broader samples the relationship between different types of obstetric and perinatal variables of birth type and infant neuropsychological development and general intelligence, in order to prevent possible psychological alterations from birth. their modulation by genetic drivers.

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