Vol 92, No 7 (2021)
Research paper
Published online: 2021-03-30

open access

Page views 1525
Article views/downloads 820
Get Citation

Connect on Social Media

Connect on Social Media

Different modes of delivery and hormonal stress response

Magdalena Bulska1, Piotr Szczesniak2, Agnieszka Pieta-Dolinska3, Patrycja Dorobek2, Jolanta Parafiniuk3, Przemyslaw Oszukowski3, Daria Orszulak-Michalak2
Pubmed: 33844248
Ginekol Pol 2021;92(7):481-486.

Abstract

Objectives: The aim of the study was to determine how the type of delivery affects the stress response cycle and the level of cortisol, progesterone and corticoliberin.
Material and methods: The study was conducted among 26 pregnant women admitted to the Gynecology and Obstetrics Ward due to an approaching delivery date or the onset of labor. The participants were aged between 20 and 41 years, with a mean age of approximately 30 years. After delivery, blood was drawn in parallel from the maternal antecubital vein, the umbilical cord vein and the umbilical cord artery. The levels of stress hormones were assessed by ELISA. The results were subjected to statistical analyses, and correlation coefficients were calculated for individual variable pairs. The analysis also examined the participation of pregnant woman in antenatal education.
Results: A high correlation was observed between cortisol and progesterone levels in venous and arterial cord blood and physiological delivery. The mean cortisol level was 247.37 ng/mL in venous cord blood and 233.59 ng/mL in arterial blood and the respective mean progesterone levels were 331.81 ng/mL and 342.36 ng/mL. The highest cortisol concentration was determined in the primiparas umbilical cord blood (236.182 ng/mL in the vein, 230.541 ng/mL in the artery). Correlation between cortisol level in venous and arterial cord blood and prenatal education was also noted (venous cord blood: r = –0.5477; F = 10.2833; p = 0.0038; cord arterial blood: r = –0, 4436; F = 5.8789; p = 0.0232).
Conclusions: The results obtained emphasize the importance of the hypothalamic-pituitary-adrenal (HPA) axis as one of the potential mechanisms actively involved in childbirth. The determined levels of cortisol and progesterone in the maternal and umbilical cord blood varied significantly depending on the type of delivery, with higher concentrations being observed in the case of natural delivery. In addition, the highest levels of cortisol were determined in primiparas; however, lowered umbilical cord blood cortisol levels were observed in pregnant women who had participated in antenatal education, regardless of the number of deliveries.

Article available in PDF format

View PDF Download PDF file

References

  1. Glover V. Maternal depression, anxiety and stress during pregnancy and child outcome; what needs to be done. Best Pract Res Clin Obstet Gynaecol. 2014; 28(1): 25–35.
  2. Bjelica A, Cetkovic N, Trninic-Pjevic A, et al. The phenomenon of pregnancy - a psychological view. Ginekol Pol. 2018; 89(2): 102–106.
  3. Valsamakis G, Chrousos G, Mastorakos G. Stress, female reproduction and pregnancy. Psychoneuroendocrinology. 2019; 100: 48–57.
  4. Pawlaczyk B. Rola hormonów w regulacji homeostazy organizmu człowieka. Homines Hominibus. 2010; 6: 7–20.
  5. Valsamakis G, Chrousos G, Mastorakos G. Stress, female reproduction and pregnancy. Psychoneuroendocrinology. 2019; 100: 48–57.
  6. Ramos IF, Guardino CM, Mansolf M, et al. Pregnancy anxiety predicts shorter gestation in Latina and non-Latina white women: The role of placental corticotrophin-releasing hormone. Psychoneuroendocrinology. 2019; 99: 166–173.
  7. Feinshtein V, Ben-Zvi Z, Sheiner E, et al. Progesterone levels in cesarean and normal delivered term placentas. Arch Gynecol Obstet. 2010; 281(3): 387–392.
  8. Farquharson RG, Dyas J, Pierrepoint CG. Cortisol concentrations in the umbilical artery and vein of breech-presenting infants at term in relation to the method of delivery. Br J Obstet Gynaecol. 1985; 92(10): 1040–1043.
  9. Yaginuma T, Izumi R. Maternal endocrine changes during labor-stress, delivery and puerperium – Correlation between duration of labor and serum cortisol levels at vaginal delivery. Acta Obst Gynaec Jpn. 1980; 32: 289–234.
  10. Löfgren M, Bäckström T. High progesterone is related to effective human labor. Study of serum progesterone and 5alpha-pregnane-3,20-dione in normal and abnormal deliveries. Acta Obstet Gynecol Scand. 1997; 76(5): 423–430.
  11. Aisien AO, Towobola OA, Otubu JA, et al. Umbilical cord venous progesterone at term delivery in relation to mode of delivery. Int J Gynaecol Obstet. 1994; 47(1): 27–31.
  12. Vogl SE, Worda C, Egarter C, et al. Mode of delivery is associated with maternal and fetal endocrine stress response. BJOG. 2006; 113(4): 441–445.