HMN 2026: How Cesarean and assisted vaginal births show similar long-term neurodevelopmental outcomes

A new population-based cohort study of more than 500,000 births in British Columbia offers reassuring evidence about the long-term safety of cesarean delivery and assisted vaginal delivery (with forceps or vacuum) when it comes to children’s neurodevelopment. Published on Jan. 30, 2026, in JAMA Network Open, the study examined rates of ADHD, autism spectrum disorder (ASD), and intellectual disability (ID) up to age 22, comparing outcomes among children whose births required medical intervention late in labor.

Researchers found:

• Comparable neurodevelopmental outcomes across cesarean, forceps, and vacuum delivery overall.
• A small increase in ADHD among children born via sequential instrument delivery (vacuum followed by forceps).
• A modest increase in intellectual disability among those born via vacuum delivery, though the absolute difference was extremely small and clinically minimal.
• No significant differences in ASD across delivery types.

The study offers clarity for families and clinicians navigating delivery decisions during the most critical stage of labor, an area where evidence has long been limited by inappropriate comparison groups.

“Rather than pointing to a single ‘safer’ intervention, the findings suggest that multiple delivery options can be used without compromising long-term child development when intervention is needed,” says Giulia Muraca, senior author of the study, McMaster University.

The content is provided for information purposes only.