Mode of delivery is associated with maternal and fetal endocrine stress response.
OBJECTIVE
To determine whether mode of delivery is associated with the endocrine stress response in mother and child.


METHODS
Prospective observational study.


METHODS
Tertiary care centre, University hospital.


METHODS
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.


METHODS
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.
Department of Obstetrics and Gynecology, Division of Obstetrics, University of Vienna Medical School, Vienna, Austria. sonja.vogl@meduniwien.ac.at
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Vogl
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Worda
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Egarter
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Bieglmayer
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Szekeres
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Huber
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Husslein
D000324:Adrenocorticotropic Hormone / Q000097:blood; D016362:Analgesia, Obstetrical; D000767:Anesthesia, Epidural; D003346:Corticotropin-Releasing Hormone / Q000097:blood; D036861:Delivery, Obstetric; D004703:Endocrine System / Q000378:metabolism*; D004837:Epinephrine / Q000097:blood; D005260:Female; D005312:Fetal Blood / Q000737:chemistry; D005333:Fetus / Q000378:metabolism*; D006728:Hormones / Q000097:blood*; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D007231:Infant, Newborn / Q000097:blood*; D007743:Labor, Obstetric / Q000097:blood*; D011247:Pregnancy; D011446:Prospective Studies; D013312:Stress, Physiological / Q000097:blood*; D001615:beta-Endorphin / Q000097:blood
D006728:Hormones; D001615:beta-Endorphin; D000324:Adrenocorticotropic Hormone; D003346:Corticotropin-Releasing Hormone; D006854:Hydrocortisone; D004837:Epinephrine