Obstetric mode of delivery and child psychological development

Background/aims: Objective of the current thesis is to investigate the potential impact of birth by Caesarean section (CS) on child psychological development, including autism spectrum disorder (ASD), attention-deficit/hyperactivity disorder (ADHD), behavioural difficulties and school performance. Structure/methods: Published literature to date on birth by CS, ASD and ADHD was reviewed (Chapter 2). Data from the UK Millennium Cohort Study (MCS) were analysed to determine the association between CS and ASD, ADHD and parent-reported behavioural difficulties (Chapter 3). The Swedish National Registers were used to further assess the association with ASD, ADHD and school performance (Chapters 4-6). Results: In the review, children born by CS were 23% more likely to be diagnosed with ASD after controlling for potential confounders. Only two studies reported adjusted estimates on the association between birth by CS and ADHD, results were conflicting and limited. CS was not associated with ASD, ADHD or behavioural difficulties in the UK MCS. In the Swedish National Registers, children born by CS were more likely to be diagnosed with ASD or ADHD. The association with elective CS did not persist when compared amongst siblings. There was little evidence of an association between birth by elective CS and poor school performance. Children born by elective CS had slight reduction in school performance. Conclusions: The lack of association with the elective CS in the sibling design studies indicates that the association in the population is most probably due to confounding. A small but significant association was found between birth by CS and school performance. However, the effect may have been due to residual confounding or confounding by indication and should be interpreted with caution. The overall conclusion is that birth by CS does not appear to have a causal relationship with the aspects of child psychological development investigated.

Cavity ring‑up spectroscopy for dissipative and dispersive sensing in a whispering gallery mode resonator

In whispering gallery mode resonator sensing applications, the conventional way to detect a change in the parameter to be measured is by observing the steady-state transmission spectrum through the coupling waveguide. Alternatively, sensing based on cavity ring-up spectroscopy, i.e. CRUS, can be achieved transiently. In this work, we investigate CRUS using coupled mode equations and find analytical solutions with a large spectral broadening approximation of the input pulse. The relationships between the frequency detuning, coupling gap and ring-up peak height are determined and experimentally verified using an ultrahigh Q-factor silica microsphere. This work shows that distinctive dispersive and dissipative transient sensing can be realised by simply measuring the peak height of the CRUS signal, which may improve the data collection rate.