Investigating Stress Response during Vaginal Delivery and Elective Cesarean Section through Assessment of Levels of Cortisol, Interleukin 6 (IL-6), Growth Hormone (GH) and Insulin-Like Growth Factor 1 (IGF-1)

Kiriakopoulos, Nikolaos; Grigoriadis, Sokratis; Maziotis, Evangelos; Philippou, Anastasios; Rapani, Anna; Giannelou, Polina; Tsioulou, Petroula; Sfakianoudis, Konstantinos; Kontogeorgi, Adamantia; Bakas, Panagiotis; Mastorakos, George; Koutsilieris, Michael; Simopoulou, Mara

doi:10.3390/jcm8081112

Cited by 25 publications

(19 citation statements)

References 46 publications

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“…Miller et al found the salivary cortisol concentration to gradually increase from the latent to the active phase in low-risk VAG deliveries, with the maximum concentration being observed within two minutes of the onset of labor [70]. In line with our results, some authors have described how VAG deliveries are associated with higher serum cortisol concentrations and more intense inflammation than elective CS deliveries, although the inflammatory response period is shorter than in the case of CS [71][72][73].…”

Section: Discussionsupporting

confidence: 90%

Maternal Microbiota, Cortisol Concentration, and Post-Partum Weight Recovery Are Dependent on Mode of Delivery

et al. 2020

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The importance of the maternal microbiota in terms of the initial bacterial seeding has previously been highlighted; however, little is currently known about the perinatal factors that could affect it. The aim of this study was to evaluate the effects of various delivery-related factors on the intestinal microbiome at delivery time and on post-partum weight retention. Data were collected from mothers (n = 167) during the first four months post-partum. A subset of 100 mothers were selected for the determination of the salivary cortisol concentration and microbiome composition at birth by 16S rRNA gene sequencing. The maternal microbiota was classified into two distinct clusters with significant differences in microbial composition and diversity. Maternal microbiota was also significantly influenced by the mode of delivery. Moreover, the salivary cortisol concentration was associated with some maternal microbiota genera and it was significantly higher in the vaginal delivery group (p = 0.003). The vaginal delivery group exhibited lower post-partum weight retention than the C-section (CS) mothers at four months post-partum (p < 0.001). These results support the hypothesis that the mode of delivery as well as the codominant hormonal changes could influence the maternal microbiota and possibly impact maternal weight recovery during the post-partum period.

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Section: Discussionsupporting

confidence: 90%

Maternal Microbiota, Cortisol Concentration, and Post-Partum Weight Recovery Are Dependent on Mode of Delivery

et al. 2020

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“…[22, 23] There is the contentious possibility, however, that the putative placental microbiota influences composition too, regardless of delivery mode. [24, 25] Another potential mechanism relates to differences between infants born by CS and VD in the intrapartum concentration of cortisol, noradrenaline and other inflammatory chemicals,[26, 27] which may result in long term neuro-immuno-endocrine, epigenetic and other changes which may influence energy metabolism.…”

Section: Introductionmentioning

confidence: 99%

Caesarean section delivery and childhood obesity in a British longitudinal cohort study

et al. 2019

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BackgroundSeveral studies reported an association between Caesarean section (CS) birth and childhood obesity. However, there are several limitations in the current literature. These include an inability to distinguish between planned and emergency CS, small study sample sizes and not adjusting for pre-pregnancy body-mass-index (BMI). We examined the association between CS delivery and childhood obesity using the United Kingdom Millennium Cohort Study (MCS).MethodsMother-infant pairs were recruited into the MCS. Use of sampling weights ensured the sample was representative of the population. The exposure was categorised as normal vaginal delivery (VD) [reference], assisted VD, planned CS and emergency CS. Childhood obesity prevalence, at age three, five, seven, eleven and fourteen years was calculated using the International Obesity Taskforce criteria. Mixed-effects linear regression models were fitted with associations adjusted for several potential confounders like maternal age, pre-pregnancy BMI, education and infant macrosomia. Linear regression models were fitted evaluating body fat percentage (BF%), at age seven and fourteen years.ResultsOf the 18,116 infants, 3872 (21.4%) were delivered by CS; 9.2% by planned CS. Obesity prevalence was 5.4%, 5.7%, 6.5%, 7.1% and 7.6% at age three, five, seven, eleven and fourteen years respectively. The mixed-effects linear regression model showed no association between planned (adjusted mean difference = 0.00; [95% confidence interval (CI) -0.10; 0.10], p-value = 0.97) or emergency CS (adjusted mean difference = 0.08; [95% CI -0.01; 0.17], p-value = 0.09) and child BMI. At age seven years, there was no association between planned CS and BF% (adjusted mean difference = 0.13; [95% CI -0.23; 0.49]); there was no association at age fourteen years.ConclusionsInfants born by planned CS did not have a significantly higher BMI or BF% compared to those born by normal VD. This may suggest that the association, described in the literature, could be due to the indications/reasons for CS birth or residual confounding.

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“…Due to improvement in anesthesia procedures, elective cesarean section is less stressful and could be further associated with less intense inflammation. 22,23 In this study, carried out exclusively in term newborns, despite the higher diurnal melatonin content found in colostrum from mothers after cesarean section, the circadian rhythm remained, and higher nocturnal levels were found in this group. This is consistent with previous studies that found higher levels of melatonin in nighttime colostrum after elective cesarean section with respect to emergency cesarean section.…”

Section: Discussionmentioning

confidence: 54%

Melatonin Content of Human Milk: The Effect of Mode of Delivery

Aparici-Gonzalo

Carrasco-García

Gombert

et al. 2020

Breastfeeding Medicine

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Objective: Cesarean section rates are increasing in developed countries and could be performed as an emergency or elective procedure. Our research aim was to determine whether elective cesarean section influences the melatonin content, the main circadian hormone, in human milk. Methods: Twenty-one women after vaginal delivery and 18 women after elective cesarean section were included. Only healthy mothers with normal newborns exclusively breastfed were recruited. Two samples of human milk were collected for each woman at three stages of lactation: colostrum, transitional milk, and mature milk; at each stage, one daytime sample and another nighttime sample were obtained. In total, 228 milk samples were studied. The melatonin content was analyzed by enzyme-linked immunosorbent assay. Results: Melatonin rhythmicity with higher melatonin content at night was maintained at each of the three stages of lactation, regardless of the type of delivery. A higher melatonin content was found in daytime colostrum after cesarean section with respect to colostrum obtained from mothers after vaginal delivery (30.3 pg/mL versus 14.7 pg/mL, p = 0.020). Melatonin content decreased progressively throughout the course of lactation in both groups. This decrease was significant when comparing transitional milk to colostrum in the cesarean group, both in the daytime (p = 0.016) and nighttime samples (p = 0.048). Conclusions: Cesarean section is associated with an increase in daytime colostrum melatonin. No difference was observed in mature milk with respect to vaginal delivery. Melatonin values in human milk decrease during the first month of lactation and circadian rhythmicity was observed irrespective of the mode of delivery.

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Investigating Stress Response during Vaginal Delivery and Elective Cesarean Section through Assessment of Levels of Cortisol, Interleukin 6 (IL-6), Growth Hormone (GH) and Insulin-Like Growth Factor 1 (IGF-1)

Cited by 25 publications

References 46 publications

Maternal Microbiota, Cortisol Concentration, and Post-Partum Weight Recovery Are Dependent on Mode of Delivery

Maternal Microbiota, Cortisol Concentration, and Post-Partum Weight Recovery Are Dependent on Mode of Delivery

Caesarean section delivery and childhood obesity in a British longitudinal cohort study

Melatonin Content of Human Milk: The Effect of Mode of Delivery

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