Umbilical cortisol levels as an indicator of the fetal stress response to assisted vaginal delivery
Umbilical cortisol levels as an indicator of the fetal stress response to assisted vaginal delivery
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DOI：
10.1016/s0301-2115(01)00298-6
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发表时间：
2001-09-01
影响因子：
2.6
通讯作者：
MacLachlan, N
中科院分区：
文献类型：
--
作者：
Gitau, R;Menson, E;MacLachlan, N
目的：虽然它是公认的，选择性剖腹产分娩是胎儿的压力小于正常的阴道分娩，很少有人注意到对婴儿的辅助delivery.Study design的影响：我们检查了皮质醇水平的静脉脐带血从出生的7个婴儿钳，10 ventose提取，28个无辅助正常阴道分娩，12个出生的选择性剖腹产。分娩后立即抽取配对母血。各组间差异有统计学意义（单因素方差分析，P < 0.0001）。产钳组最高，剖宫产组最低，均与正常阴道分娩组有差异（P = 0.019和P = 0.046）。分娩时间长短或缓解疼痛的方法对皮质醇水平没有影响。产妇的价值观是相似的，在不同的群体，确认观察到的差异来自fetus.Conclusions：有越来越多的证据表明，胎儿或新生儿经历的压力可以有长期的影响下丘脑-垂体-肾上腺轴的功能在以后的生活。我们推测，一些辅助分娩造成的压力可能有助于这一点。(C)2001爱思唯尔科学爱尔兰有限公司保留所有权利。
Objectives: While it is well established that delivery by elective caesarean section is less stressful for the fetus than normal vaginal delivery, little attention has been paid to the effect on the baby of an assisted delivery.Study design: We examined cortisol levels in venous cord blood from seven babies born by forceps, 10 by ventouse extraction, 28 by unassisted normal vaginal delivery, and 12 born by elective caesarean. Paired maternal bloods were taken immediately after delivery.Results: Cord blood cortisol. values were significantly different in the different groups (one-way ANOVA, P < 0.0001). The forceps group had the highest values and the caesarean group the lowest; both were different from the normal vaginal delivery group (P = 0.019 and P = 0.046, respectively). There was no effect of length of labour, or method of pain relief on cortisol levels. Maternal values were similar in the different groups, confirming that the differences observed derived from the fetus.Conclusions: There is increasing evidence that the stress experienced by the fetus or neonate can have long-term effects on the function of the hypothalamic-pituitary-adrenal axis in later life. We speculate that the stress caused by some assisted deliveries may contribute to this. (C) 2001 Elsevier Science Ireland Ltd. All rights reserved.