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Mode of delivery is associated with maternal and fetal endocrine stress response
Author(s) -
Vogl SE,
Worda C,
Egarter C,
Bieglmayer C,
Szekeres T,
Huber J,
Husslein P
Publication year - 2006
Publication title -
bjog: an international journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.157
H-Index - 164
eISSN - 1471-0528
pISSN - 1470-0328
DOI - 10.1111/j.1471-0528.2006.00865.x
Subject(s) - medicine , caesarean section , vaginal delivery , endocrine system , obstetrics , population , pregnancy , fetus , umbilical cord , adrenocorticotropic hormone , anesthesia , hormone , genetics , environmental health , anatomy , biology
Objective To determine whether mode of delivery is associated with the endocrine stress response in mother and child. Design Prospective observational study. Setting Tertiary care centre, University hospital. Population A total of 103 nulliparous women with uncomplicated singleton pregnancies at term undergoing either spontaneous labour for vaginal delivery or delivering by caesarean section without labour. Thirty women delivered vaginally without any pain relief, 21 women delivered vaginally with epidural anaesthesia, 23 women had ventouse extraction and 29 women underwent caesarean section with epidural analgesia. Methods After delivery, maternal and umbilical cord blood was collected for determination of different stress‐associated hormones. Main outcome measures Concentrations of epinephrine (EP), norepinephrine (NOR), adrenocorticotropic hormone (ACTH), cortisol (CORT), prolactin (PRL), corticotropin‐releasing factor and beta‐endorphin (BE). Results Caesarean section was associated with significantly lower maternal concentrations of EP, NOR, ACTH, CORT, PRL and BE and lower newborn levels of EP, NOR and CORT compared with all other modes of delivery. Concentrations of EP, ACTH and BE differed significantly in newborns delivered by normal vaginal delivery, vaginal delivery with epidural anaesthesia and ventouse extraction. Conclusions The mode of delivery and analgesia used during birth are associated with maternal and fetal endocrine stress responses.