title: Stress and pain response of neonates after spontaneous birth and vacuum-assisted and cesarean delivery.
abstract: OBJECTIVE
  The objective of the study was to compare the stress response and pain expression of newborns (NBs) in the early postpartum period.
  
  
  METHODS
  This was a prospective study with 280 NBs enclosed at 3 Swiss university hospitals. Stress response and pain reaction were analyzed according to the mode of delivery: elective cesarean section (ELCS), spontaneous vaginal delivery, and assisted vaginal delivery by vacuum extraction (VE). Saliva cortisol and clinical pain expression were evaluated after delivery and before and after heel prick for metabolic screening.
  
  
  RESULTS
  Significant differences were evident during the first 72 hours postpartum with highest nominations in the VE group. Meconium-stained amniotic fluid was the only intrapartum stress factor with an impact on clinical pain expression.
  
  
  CONCLUSIONS
  NBs delivered vaginally show a higher incidence of stress response and pain expression than infants of the ELCS group. The long-term impact of these findings remains to be determined.
authors.affiliation: Department of Obstetrics and Gynecology, University Hospital Bern, Switzerland.
authors.forename: Christine
authors.initials: C
authors.lastname: Schuller
authors.forename: Nina
authors.initials: N
authors.lastname: Känel
authors.forename: Olivia
authors.initials: O
authors.lastname: Müller
authors.forename: André Boris
authors.initials: AB
authors.lastname: Kind
authors.forename: Eva Maria
authors.initials: EM
authors.lastname: Tinner
authors.forename: Irene
authors.initials: I
authors.lastname: Hösli
authors.forename: Roland
authors.initials: R
authors.lastname: Zimmermann
authors.forename: Daniel
authors.initials: D
authors.lastname: Surbek
mesh_terms: D000653:Amniotic Fluid; D002585:Cesarean Section / Q000009:adverse effects; D036861:Delivery, Obstetric / Q000009:adverse effects* / Q000379:methods; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000032:analysis; D007231:Infant, Newborn; D008297:Male; D008470:Meconium; D058748:Pain Perception; D049590:Postpartum Period; D011247:Pregnancy; D011446:Prospective Studies; D012463:Saliva / Q000737:chemistry; D013312:Stress, Physiological; D014620:Vacuum Extraction, Obstetrical / Q000009:adverse effects
chemical_list: D006854:Hydrocortisone