Plasma immunoreactive beta-endorphin, ACTH and cortisol concentrations in mothers and their neonates immediately after delivery — their relationship to the duration of labor

Bacigalupo, G; Langner, K.; Schmidt, Stephan; Saling, E.

doi:10.1515/jpme.1987.15.1.45

Cited by 34 publications

(17 citation statements)

References 16 publications

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“…28 VD neonate also exhibits significantly higher plasma levels of b-endorphin than infant born by CS, which may further promote this difference. [4][5][6] The similar baseline HR in our VD and CS infant with gradual increase in HR after VD in response to pain and cold stimulus during the first 4 h after birth may involve this endogen mechanism of stress-induced analgesia. 29 The rapid decline in circulating levels of b-endorphin during the initial 2 h following VD is in agreement with our findings.…”

Section: Discussionsupporting

confidence: 57%

“…This hypothesis receives support from a number of studies demonstrating significantly higher plasma levels of catecholamine (CA) 3 and b-endorphin in infants born by VD than by CS. [4][5][6] Historically as early as 1872, Charles Darwin described facial expression and cry responses followed pain as an important evidence of emotional feeling in the newborn infant, 7 confirmed by a considerable amount of research since then. Facial expressions are more consistent indicators of pain than cry or body movements.…”

Section: Introductionmentioning

confidence: 99%

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Mode of delivery modulates physiological and behavioral responses to neonatal pain

et al. 2008

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Objective: To study whether the mode of delivery alters pain expression.Study Design: Full-term infants born by vaginal delivery or elective caesarean section were observed following high-and low-intensity pain stimuli, with recording of electrocardiogram, facial expression and vocalization.Result: Graded physiological and behavioral responses occurred, with greater responses to higher than lower intensity pain stimuli. Elevation in heart rate following both stimuli increased with time after vaginal delivery. Infants delivered by elective caesarean section showed stronger facial expressions and briefer time in vocalizations response to both interventions. Conclusion:Diminished responses following vaginal delivery suggest that physiological events associated with a normal delivery reduce the physiologic and sympathoadrenal activation by nociceptive mechanisms. Pain and stress reactivity appear to be inhibited during fetal life and sensory inputs during vaginal delivery may reverse this inhibition. To minimize neonatal pain, we recommend that postnatal invasive procedures to be performed shortly after vaginal birth.

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Section: Discussionsupporting

confidence: 57%

Section: Introductionmentioning

confidence: 99%

Mode of delivery modulates physiological and behavioral responses to neonatal pain

et al. 2008

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“…for and the response to resuscitation, the Apgar score is at best ~h , acute asphyxia group (Table consisted of 34 infants, an indirect indicator of the effects of hypoxia, hypercarbia, and born after uneventful pregnancy and spontaneous labor, but the circulatory disturbance on the fetus and newborn (1). Maternal deliveries were complicated by severe asphyxia, defined as an analgesia or anesthesia and prematurity are associated with low Apgar score of 6 or less at min and/or an umbilical arterial p~ scores in the absence of asphyxia, and poor correlation has been of 7.05 or less. Fetal distress necessitated instrumented delivery found between the Apgar score and the pH in arterial in 18 cases, 1 1 by cesarean section, six with vacuum extraction, blood (2).…”

Section: Methodsmentioning

confidence: 99%

“…(Pediatr Res 24: 490-494,1988) Abbreviations AVP, arginine vasopressin EP, erythropoietin HX, hypoxanthine Fetal asphyxia and delivery trigger a rapid increase in the secretion of several "stress" hormones, e.g. catecholamines, glucocorticoids, ACTH, p-endorphin, and AVP, which in turn mediate the cardiovascular and metabolic adaptation to asphyxia (4)(5)(6). A more specific response to hypoxia is an increase in the synthesis of EP, followed by elevation of plasma levels (7,8).…”

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confidence: 99%

Cord Plasma Vasopressin, Erythropoietin, and Hypoxanthine as Indices of Asphyxia at Birth

et al. 1988

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ABSTRACT. To assess the value of cord plasma arginine vasopressin (AVP), erythropoietin (EP), and hypoxanthine (HX) as indices of asphyxia, we studied 62 infants of mothers with preeclampsia, 34 acutely asphyxiated infants, with 5-min Apgar score 5 6 and/or umbilical arterial pH 57.05, and 38 control infants. Umbilical arterial AVP in the asphyxia group (geometric mean; 95% confidence interval: 180; 92-350 pg/ml) was higher than in the control group (23; 8-66, p = 0.002) and correlated with umbilical arterial pH ( r = -0.447, p = 0.028). AVP levels in the preeclampsia group did not differ from controls. Cord venous E P was higher in infants delivered by elective cesarean section from women with severe preeclampsia (115; 75-177 mU/ml, p < 0.001) than in control infants (23; 18-27); in the whole group EP correlated with pH (r = -0.493, p < 0.001). E P in the asphyxia group was similar (46; 35-65) to controls (40; 33-47) and did not correlate with pH. Cord arterial HX in the preeclampsia group was similar to controls (12.3; 9.5-16.0 pmol/liter), but elevated in the asphyxia group (23.7; 17.6-31.8, p = 0.001), in which HX correlated with pH ( r = 0.558, p = 0.008) and AVP ( r = 0.588, p = 0.005). E P did not correlate with AVP or HX in any group, nor did any of the variables correlate with the Apgar score. We conclude that cord plasma AVP and HX reflect acute asphyxia, whereas E P is elevated after more prolonged hypoxia. (Pediatr Res 24: 490-494,1988) Abbreviations AVP, arginine vasopressin EP, erythropoietin HX, hypoxanthine Fetal asphyxia and delivery trigger a rapid increase in the secretion of several "stress" hormones, e.g. catecholamines, glucocorticoids, ACTH, p-endorphin, and AVP, which in turn mediate the cardiovascular and metabolic adaptation to asphyxia (4-6). A more specific response to hypoxia is an increase in the synthesis of EP, followed by elevation of plasma levels (7,8). If tissue hypoxia becomes more severe, cellular ATP concentrations cannot be maintained, and increased concentrations of the purine nucleotide catabolic products, HX, xanthine, and uric acid, appear in body fluids (9).The aim of our study was to assess if three components of this physiological response, AVP, EP, and HX, could be useful as biochemic indices of the severity of asphyxia. Two different clinical conditions were studied: acute severe birth asphyxia and maternal preeclampsia, the latter as an example of a chronic but less severe compromise in fetal oxygen and nutrient supply.

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“…A asfixia também desencadeia um rápido aumento na secreção de vários hormônios, entre eles catecolaminas 2 , glicocorticóides [2][3][4] , ACTH 4 , ß-endorfinas 4 , hormônio antidiurético [5][6][7][8] , aldosterona 1,2,9,10 , renina 11 e peptídeo atrial natriurético 9,12 , bem como uma diminuição na insulina 1 .…”

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Efeitos da asfixia perinatal sobre os hormônios tireoidianos

Pereira¹,

Procianoy

2001

J. Pediatr. (Rio J.)

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ResumoObjetivo: verificar o efeito da asfixia perinatal sobre os hormô-nios tireóideos.Métodos: foi realizado um estudo de caso-controle, no hospital de Clínicas de Porto Alegre, envolvendo 17 recém-nascidos a termo asfixiados (A) e 17 não-asfixiados (N), pareados conforme a cor, sexo, tipo de parto, idade gestacional e peso de nascimento. Foram coletados T4, T3, T4 livre, T3 reverso e TSH do sangue do cordão e do recém-nascido com 18 a 24 horas de vida, entre os que sofreram ou não asfixia perinatal.Resultados: no sangue de cordão, não houve diferença na dosagem dos hormônios tireóideos, com exceção do T3 reverso, que foi mais elevado no grupo que sofreu asfixia [mediana (percentis 25-75):A= 2(1,4-2); N= 1,41(1,13-1,92); p=0,037]. Com 18 a 24 horas de vida, foram significativamente menores no grupo de asfixiados, com exceção do T3 reverso, que foi semelhante entre os dois grupos [média ± DP: T4 A= 9,79 ± 2,59; N=14,68 ± 3,05; p<0,001/ mediana T3 A= 40,83(37,4-80,4); N= 164(56,96-222,5); P=0,003/ média ± DP T4 livre A=1,85 ± 0,92; N= 2,8 ± 0,74; p=0,004/ mediana T3 reverso A= 1,54(1,16-1,91); N= 1,31(0,87-2); p=0,507/ TSH A= 9,1(6,34-12,95); N=14,5(12,9-17,85); p=0,008].Conclusões: nossos dados sugerem que os níveis diminuídos de T4, T4 livre e T3 no recém-nascido asfixiado com 18 a 24 horas de vida são secundários aos níveis diminuídos de TSH. Além disso, os valores baixos de T3 e normais de T3 reverso podem refletir alteração no metabolismo periférico do T4.J Pediatr (Rio J) 2001; 77 (3): 175-78: hormônios da tireóide, asfixia perinatal, síndrome do doente eutireóideo. AbstractObjective: to verify the effect of perinatal asphyxia on thyroid hormone levels in term newborn infants.Methods: we carried out a case-control study with 17 term and asphyxiated (A) and 17 term and control (N) newborn infants at the Hospital de Clínicas de Porto Alegre. Patients were paired according to color of skin, sex, mode of delivery, gestational age, and weight at birth. We collected plasmatic T4, T3, free T4, reverse T3, and TSH of the umbilical cord after 18 to 24 hours of life and from asphyxiated and control newborn infants.Results: there were no differences in thyroid hormones of cord blood, with the exception of reverse T3, which was higher in A than in controls [median (percentile 25-75): A= 2(1.4-2); N= 1.41 (1.13-1.92); P=0.037)]. Thyroid hormone levels were lower in A than in controls on 18-24-hour after birth samples, except for reverse T3, which was similar in both groups [average ± SD: T4 A= 9.79 ± 2.59; N=14.68 ± 3.05; P<0.001; median T3 A= 40.83 (37.4-80.4); N= 164 (56.96-222.5); P=0.003; average ± SD: free T4 A=1.85 ± 0.92; N= 2.8 ± 0.74; P=0.004; median: reverse T3 A=1.54 (1.16-1.91); N=1.31(0.87-2); P=0.507; TSH A=9.1 (6.34-12.95); N=14.5(12.9-17.85); P=0.008].Conclusions: our data suggests that lower T4, free T4, and T3 levels are secondary to lower TSH levels in asphyxiated newborns; also, peripheral metabolism of T4 in asphyxiated infants can be altered due to low T3 and normal reverse T3 levels.J Pediatr (Rio...

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Plasma immunoreactive beta-endorphin, ACTH and cortisol concentrations in mothers and their neonates immediately after delivery — their relationship to the duration of labor

Cited by 34 publications

References 16 publications

Mode of delivery modulates physiological and behavioral responses to neonatal pain

Mode of delivery modulates physiological and behavioral responses to neonatal pain

Cord Plasma Vasopressin, Erythropoietin, and Hypoxanthine as Indices of Asphyxia at Birth

Efeitos da asfixia perinatal sobre os hormônios tireoidianos

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