Forceps babies 'more likely to behave badly' while those born by Caesareans 'are calmer'

Babies born with the help of forceps or a suction cup are more likely to have emotional problems, research suggests.

The study reinforces previous findings that assisted delivery techniques produce high levels of stress hormones that may affect development.

The latest research also showed children born after a caesarean requested by their mother have fewer emotional and behavioural problems. In pre-school, they were found to be much less likely to suffer from anxiety, aggression and attention disorders.

The Chinese study found babies born with the aid of forceps were more likely to be aggressive as young children, but Caesarean babies were calmer

The study, which involved 4,190 children from south-east China, looked at the links between birthing methods and child behaviour.

Roughly half of Chinese babies are delivered by caesarean section - the highest rate anywhere and twice that of Britain, according to the World Health Organisation.

The parents in the Chinese study were asked to fill in a survey on their children between the age of four and six, reported BJOG: An International Journal of Obstetrics and Gynaecology.

The results showed those born through an assisted delivery were 40 per cent more likely to be among the worst affected by emotional and behavioural problems - possibly related to high levels of the stress hormone cortisol.

Immediately after birth, umbilical cord blood cortisol levels have been found to be lowest in babies born by elective caesarean, followed by spontaneous birth. The highest levels are found in assisted deliveries where forceps or a suction cup is used because labour is prolonged and complications may have developed.

Previous studies have suggested these children experienced the highest levels of stress at birth.

Jianmeng Liu, a professor at the Institute of Reproductive and Child Health in Beijing and joint author on the research paper, said it was the first examination of the effect on child behaviour of caesarean delivery on maternal request.

'Cortisol levels have been linked to childhood psychopathology, however, more studies are still needed to look at this in more detail,' he said.

Professor Philip Steer, editor-in-chief of BJOG, said: 'With the rising rates of elective caesarean section in China and in other countries, it is interesting to see from this research that there is a low impact on childhood psychopathology.'

An estimated 7 per cent of all NHS caesareans - around 10,000 babies a year - follow a request from the mother that is not based on medical grounds.

Caesarean births are increasing in China, particularly in the richer south-eastern parts of the country where rates rose to 56 per cent in 2006 from 22 per cent in 1994.

Surgical delivery on request by mothers is a major contributor to this trend.