title: Global and single gene DNA methylation in umbilical cord blood cells after elective caesarean: a pilot study.
abstract: OBJECTIVE
  To evaluate global and single gene methylation patterns as a sign for epigenetic modulation of the immune system in infants born by elective cesarean section (CS) and vaginal delivery (VD).
  
  
  METHODS
  For this prospective pilot study a two step approach was chosen. Initially 41 newborn infants comprising 23 delivered by VD and 18 delivered by elective CS were included. Global DNA methylation of umbilical cord blood was determined. In a second step, methylation status of 96 single genes linked to T cell activation, cytokine production, inflammatory response, and stem cell transcription was evaluated in 48 newborn infants, 20 delivered by VD and 28 delivered by CS.
  
  
  RESULTS
  Global methylation did not differ significantly between CS and VD (p=0.732). The methylation status was low (threshold: ≤3%) for the majority of single genes (n=92) in both groups. FOXP3, CD7, ELA2, and IRF1 showed hypermethylation in both groups. In the CS group, ELA2 (p<0.001) and IRF1(p =0.017) showed significantly higher methylation compared to the VD group.
  
  
  CONCLUSIONS
  We found no difference in global methylation between newborn infants in the VD group compared to the elective CS group. Methylation of single genes was significantly higher in newborn infants delivered by elective CS. Further research is needed to determine the significance of theses findings.
authors: Department of Obstetrics and Gynecology, Medical University of Vienna, Vienna, Austria.
authors: Maximilian B
authors: MB
authors: Franz
authors: Department of Obstetrics and Gynecology, Medical University of Vienna, Vienna, Austria.
authors: Mariella
authors: M
authors: Poterauer
authors: Department of Obstetrics and Gynecology, Medical University of Vienna, Vienna, Austria.
authors: Marie
authors: M
authors: Elhenicky
authors: Clinical Institute of Pathology, Medical University of Vienna, Vienna, Austria.
authors: Susanne
authors: S
authors: Stary
authors: Clinical Institute of Pathology, Medical University of Vienna, Vienna, Austria.
authors: Peter
authors: P
authors: Birner
authors: Department of Surgery, Medical University of Vienna, Vienna, Austria.
authors: Ursula
authors: U
authors: Vinatzer
authors: Department of Obstetrics and Gynecology, Medical University of Vienna, Vienna, Austria.
authors: Peter
authors: P
authors: Husslein
authors: Department of Obstetrics and Gynecology, Medical University of Vienna, Vienna, Austria. Electronic address: berthold.streubel@meduniwien.ac.at.
authors: Berthold
authors: B
authors: Streubel
authors: Department of Obstetrics and Gynecology, Medical University of Vienna, Vienna, Austria.
authors: Heinrich
authors: H
authors: Husslein
mesh_terms: D002585:Cesarean Section; D019175:DNA Methylation; D017558:Elective Surgical Procedures; D005260:Female; D005312:Fetal Blood / Q000378:metabolism*; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D010865:Pilot Projects; D011247:Pregnancy; D011446:Prospective Studies
keywords: Birth; Cesarean section; DNA methylation; Epigenetic modulation