别慌，科学家还没有发现剖腹产会导致自闭症

Few fields of medical research attract controversy quite like those associated with childbirth and the risk of developmental disorders. Combined, it's a sensitive topic primed for a heated debate.

很少有医学研究领域像那些与分娩和发育障碍风险相关的研究那样引起争议。总之，这是一个敏感的话题，将引发一场激烈的辩论。

A recent review linking caesarean section deliveries with autism could be interpreted as a reason to push for a vaginal birth instead. But despite the impressive appearance of the meta-study's numbers, some experts argue it falls short of warranting advice for expectant mothers.

最近的一篇综述将剖腹产与自闭症联系起来，这可以被解释为推动顺产的一个原因。然而，尽管这项荟萃研究的数据令人印象深刻，但一些专家认为，它并没有为孕妇提供充分的建议。

Scientists from Swedish and Spanish research institutes compiled data on a whopping 20 million caesarean and vaginal deliveries recorded in 61 observational studies, some of which were conducted as far back as the 1960s.

瑞典和西班牙研究机构的科学家收集了61项观察性研究中记录的2000万例剖腹产和阴道分娩的数据，其中一些研究早在20世纪60年代就开始了。

Their results suggest children delivered by C-section have a 1.33 times greater risk of falling on the autism spectrum, compared with children delivered vaginally. They also found similar numbers regarding the development of attention deficit disorder, finding 1.17 times increased risk for those delivered via C-section.

他们的研究结果表明，剖腹产的孩子患自闭症的风险是顺产孩子的1.33倍。他们还发现，在注意力缺陷障碍的发展方面也有类似的数据，通过剖腹产分娩的风险增加了1.17倍。

To most parents, any chance that their unborn child could face more hardship than necessary is reason to take notice. But amid emotional debates over whether caesarean deliveries lead to fatter babies or give babies the right kind of microbes, mothers already face intense judgement over their choice of birthing method.

对大多数父母来说，他们未出生的孩子可能会面临比需要更多的困难，这是值得注意的原因。但是，在关于剖腹产是否会导致更胖的婴儿或给婴儿合适的微生物的情感争论中，母亲们在选择分娩方法时已经面临着激烈的判断。

Knowing there is a chance of an increased risk is all well and good. Understanding how it should affect our decisions is something else entirely.

知道风险有增加的可能是件好事。理解它应该如何影响我们的决定完全是另一回事。

University of Queensland obstetrics researcher Gino Pecoraro sees the significance of this kind of research in making sound decisions.

昆士兰大学产科研究员吉诺·佩科拉罗认为，这种研究对于做出正确的决定具有重要意义。

"Before undergoing any treatment, particularly elective treatment, it is important that doctors make patients aware of the options they have and their potential risks and benefits," says Pecoraro.

佩科拉罗说：“在接受任何治疗，特别是选择性治疗之前，医生必须让患者知道他们的选择以及潜在的风险和益处。”

But he's also concerned about reading too much into the study's conclusions.

但他也担心对研究结论的解读太多。

Calculating the chances any one child will be diagnosed with autism spectrum disorder is easier said than done. That figure could be as low as 0.6 percent in some parts of the world. The CDC estimates it could be as high as 1.69 percent.

计算任何一个孩子被诊断为自闭症谱系障碍的可能性，说起来容易做起来难。在世界某些地区，这个数字可能低至0.6%。疾病预防控制中心的估计，可能高达1.69%。

If we use the CDC estimate, the absolute risk of autism increases just a little to 2.24 percent for C-section births, according to this latest research. Not only does this put a small jump in risk into perspective, it also reflects the difficulties in defining disorders like autism with consistency.

如果我们使用疾控中心的估计，根据最新的研究，剖腹产婴儿患自闭症的绝对风险只增加了一点点，达到2.24%。这不仅使人们对风险有了一个小的飞跃，也反映出在一致性地定义自闭症等疾病方面的困难。

Pecoraro points out changes to the way researchers have diagnosed such disorders over time complicates research. While tens of millions of data samples seems impressive, it could be a problem if they don't agree on how autism should be defined.

佩科拉罗指出，随着时间的推移，研究人员诊断这类疾病的方式发生了变化，这使得研究变得复杂。虽然数以千万计的数据样本似乎令人印象深刻，但如果他们不同意如何定义自闭症，这可能是个问题。

It might not be enough to dismiss the study outright, but Pecoraro does urge caution in reading too deeply into its results.

这可能还不足以彻底否定这项研究，但佩科拉罗确实敦促人们谨慎对待研究结果。

"This study is certainly interesting and begs further prospective research be undertaken to try and answer the question of whether delivery by caesarean section increases the burden of mental health issues in children," he says.

他说：“这项研究当然很有趣，并要求进行进一步的前瞻性研究，试图回答剖腹产是否会增加儿童心理健康问题的负担这一问题。”

"Ultimately, this study does not answer this question, but merely comes up with the correct recommendation that 'further research is required'."

“最终，这项研究并没有回答这个问题，只是提出了‘需要进一步研究’的正确建议。”

It goes without saying that future investigations will build or shake confidence in the findings. But as controversial as the study might be, it's far from the first to identify a link.

不用说，未来的调查将建立或动摇人们对调查结果的信心。尽管这项研究可能存在争议，但它远不是第一个确定两者之间存在关联的研究。

The question over whether a correlation exists isn't what concerns so many researchers. It's that without clearer evidence of a mechanism, it's hard to judge any single preference for a caesarean delivery over a vaginal one given both come with serious risks and benefits.

关于相关性是否存在的问题并不是那么多研究人员关心的问题。这是因为，如果没有更明确的机制证据，很难判断剖腹产比阴道分娩的任何一种偏好，因为两者都具有明显的风险和好处。