title: Mode of delivery may influence neonatal responsiveness to maternal separation.
abstract: BACKGROUND
  Maternal-infant separation (MIS) is a highly stressful situation for the neonate.
  
  
  METHODS
  A study was conducted to observe and describe the reactions of term neonates to brief maternal separation and restoration of skin contact within the first 48 h of life, and to assess whether the mode of delivery influences neonatal responsiveness. A brief maternal-infant separation situation was videotaped to observe the reactions of the newborns within the first 12-48 h of life. Characteristics observed in the newborns were: the Moro reflex, spreading out arms and feet, looking at the mother, presence/lack of crying, and some dichotomous variables (present or lacking); in mothers: adult speech, "motherese" speech, speaking to another adult present in the room, singing, clicking, tapping on the diaper, rocking, kissing the baby, touching toes, touching hands, changing position, making loving comments, calling the newborn by his/her name and touching his/her back. Crying on restoration of contact was measured.
  
  
  RESULTS
  Ten neonates born by planned C-section and 21 neonates born by oxytocin-induced vaginal delivery were included. No behavioral differences were observed according to the mode of delivery. Neonates born by vaginal delivery took longer (64.8±8.6 s) to calm down than those born by C-section (0.9±1.4 s) (p=0.004). A correlation was observed between cortisol concentrations at birth and the time required to calm the baby down (r=0.41; p=0.02).
  
  
  CONCLUSIONS
  Neonates born by a planned C-section cried much less on maternal separation, which might indicate an altered attachment behavior and altered response to stress. Further studies are needed to determine the potential long-term implications of variations in mother-infant attachment during the first days of life.
authors.affiliation: Autonomous University of Madrid, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain. ibone.olza@salud.madrid.org
authors.forename: Ibone
authors.initials: I
authors.lastname: Olza Fernández
authors.forename: Miguel Angel
authors.initials: MA
authors.lastname: Marín Gabriel
authors.forename: Lourdes
authors.initials: L
authors.lastname: García Murillo
authors.forename: Ana María
authors.initials: AM
authors.lastname: Malalana Martinez
authors.forename: Valeria
authors.initials: V
authors.lastname: Costarelli
authors.forename: Isabel
authors.initials: I
authors.lastname: Millán Santos
mesh_terms: D000328:Adult; D002585:Cesarean Section; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D018730:Infant Behavior / Q000502:physiology*; D007231:Infant, Newborn; D007751:Labor, Induced; D008425:Maternal Behavior / Q000502:physiology*; D008426:Maternal Deprivation; D009034:Mother-Child Relations; D010121:Oxytocin; D011446:Prospective Studies; D018709:Statistics, Nonparametric; D013997:Time Factors; D014741:Video Recording
chemical_list: D010121:Oxytocin; D006854:Hydrocortisone