Table 3 Adjusteda Association of Mode of Delivery Separated by Unassisted and Assisted Vaginal Delivery with Psychological Well-Being in Hong Kong’s “Children of 1997” Birth Cohort (Multiple Imputation)

From: Mode of delivery and child and adolescent psychological well-being: Evidence from Hong Kong’s “Children of 1997” birth cohort

Psychological Well-Being

Model 1a, b

Model 2a, c

Model 3a. d

Assisted Vaginal Delivery

Cesarean

Assisted Vaginal Delivery

Cesarean

Assisted Vaginal Delivery

Cesarean

β (95% CI)

β (95% CI)

β (95% CI)

β (95% CI)

β (95% CI)

β (95% CI)

Rutter scores at ~7 years (n = 6,294)

Total

0.03 (−0.38, 0.43)

−0.29 (−0.63, 0.05)

0.08 (−0.34, 0.50)

−0.27 (−0.63, 0.10)

−0.12 (−0.55, 0.31)

−0.31 (−0.68, 0.07)

Conduct

−0.07 (−0.16, 0.02)

−0.04 (−0.12, 0.03)

−0.05 (−0.14, 0.04)

−0.04 (−0.12, 0.04)

−0.10 (−0.19, −0.003)

−0.05 (−0.13, 0.03)

Emotional

0.09 (0.01, 0.18)

0.04 (−0.03, 0.11)

0.05 (−0.04, 0.13)

−0.02 (−0.10, 0.05)

0.003 (−0.09, 0.09)

−0.04 (−0.12, 0.04)

Hyperactivity

−0.05 (−0.16, 0.05)

−0.13 (−0.22, −0.04)

0.001 (−0.11, 0.11)

−0.08 (−0.18, 0.01)

−0.03 (−0.14, 0.08)

−0.09 (−0.19, 0.01)

Rutter scores at ~11 years (n = 5,598)

Total

−0.26 (−0.69, 0.17)

−0.20 (−0.57, 0.16)

−0.13 (−0.56, 0.31)

−0.07 (−0.47, 0.32)

−0.28 (−0.73, 0.17)

−0.11 (−0.52, 0.30)

Conduct

−0.03 (−0.12, 0.06)

−0.02 (−0.10, 0.06)

−0.002 (−0.10, 0.09)

0.004 (−0.08, 0.09)

−0.04 (−0.14, 0.06)

0.001 (−0.09, 0.09)

Emotional

0.03 (−0.06, 0.12)

0.06 (−0.02, 0.14)

−0.01 (−0.10, 0.09)

−0.002 (−0.09, 0.08)

−0.03 (−0.13, 0.07)

−0.01 (−0.10, 0.08)

Hyperactivity

−0.14 (−0.24, −0.03)

−0.12 (−0.22, −0.03)

−0.06 (−0.17, 0.05)

−0.04 (−0.14, 0.06)

−0.08 (−0.19, 0.04)

−0.05 (−0.15, 0.05)

Self-esteem scores (n = 6,937)

Overall

1.42 (0.93, 1.90)

0.87 (0.45, 1.28)

0.51 (0.02, 1.00)

−0.10 (−0.53, 0.34)

0.29 (−0.21, 0.80)

−0.27 (−0.73, 0.18)

General

0.57 (0.35, 0.80)

0.32 (0.13, 0.51)

0.24 (0.01, 0.47)

−0.04 (−0.24, 0.16)

0.15 (−0.09, 0.38)

−0.11 (−0.32, 0.11)

Social

0.17 (0.05, 0.29)

0.05 (−0.05, 0.16)

−0.002 (−0.13, 0.12)

−0.13 (−0.24, −0.02)

−0.002 (−0.13, 0.13)

−0.12 (−0.24, −0.004)

Academic

0.39 (0.26, 0.52)

0.29 (0.18, 0.40)

0.19 (0.06, 0.32)

0.08 (−0.03, 0.20)

0.11 (−0.02, 0.25)

0.01 (−0.11, 0.13)

Parent-related

0.28 (0.15, 0.41)

0.20 (0.09, 0.31)

0.08 (−0.05, 0.21)

−0.01 (−0.13, 0.10)

0.04 (−0.10, 0.18)

−0.06 (−0.18, 0.06)

Depressive symptoms (n = 5,797)

PHQ-9 scores

−0.26 (−0.50, −0.02)

−0.11 (−0.31, 0.09)

−0.15 (−0.40, 0.09)

0.04 (−0.17, 0.26)

−0.09 (−0.34, 0.16)

0.13 (−0.10, 0.35)

  1. Abbreviation: HK, Hong Kong; CI, confidence interval
  2. aReference group: Unassisted vaginal delivery.
  3. bAdjusted for sex, age at assessment and survey mode (PHQ-9 scores).
  4. cAdditionally adjusted for highest parental education, parental occupation, household income per head, mother’s birthplace and birth hospital.
  5. dAdditionally adjusted for birthweight, gestational age, parity, maternal age, maternal BMI, gestational diabetes and preeclampsia.
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