ECE2020 Audio ePoster Presentations Adrenal and Cardiovascular Endocrinology (121 abstracts)
Investigating differences regarding stress hormonal response during vaginal delivery and elective caesarean section
George Mastorakos 1 , Nikolaos Kiriakopoulos 2 , Sokratis Grigoriadis 3,4 , Evangelos Maziotis 3,4 , Anastasios Philippou 4 , Anna Rapani 3,4 , Polina Giannelou 4,5 , Petroula Tsioulou 3,4 , Konstantinos Sfakianoudis 5 , Adamandia Kontogeorgi 4 , Panagiotis Bakas 3 , Michael Koutsilieris 4 & Mara Simopoulou 3,4
1Unit of Endocrinology, Diabetes mellitus and Metabolism, Second Department of Obstetrics and Gynecology, Aretaieion Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece; 2General Maternal Hospital of Athens “Elena Venizelou”, Fifth Department of Obstetrics and Gynecology, Athens, Greece; 3 Aretaieion Hospital, Medical School, National and Kapodistrian University of Athens, Assisted Reproduction Unit, Second Department of Obstetrics and Gynecology, Athens, Greece; 4Medical School, National and Kapodistrian University of Athens, Laboratory of Experimental Physiology, Athens, Greece; 5Genesis Athens Clinic, Centre for Human Reproduction, Chalandri, Athens, Greece
Introduction: Despite the fact that CS is widely employed, further investigation on the topic of the physiology vis a vis this type of delivery is required, especially regardingstress related hormonal response during this practice. The aim of this study is to provide data regarding stress related hormonal response during Vaginal Delivery (VD) and elective CS evaluating levels of Cortisol, Interleukin 6 (IL-6), Growth Hormone (GH) and Insulin-like Growth Factor 1 (IGF-1).
Materials and methods: The sample size of this study (n = 50) was divided in two groups, namely the VD (n = 26) and the CS (n = 24)groups. The inclusion criteria were the following: healthy women aged 20–43 years, with hitherto uncomplicated singleton pregnancies who underwent spontaneous VD or elective CS, at a gestational age ranging from 37–40 weeks. Peripheral blood samples were collected at three different time-points. Time-Point 1 (TP1): samples collected at the first stage of labor for VD or 30 minutes following admission to the hospital for CS. Time-Point 2 (TP2): samples collected 120 minutes following placenta delivery. Time-Point 3 (TP3): samples collected 48 hours following placenta delivery. Umbilical cord blood samples were collected following placenta delivery. Evaluation of hormonal levels were performedvia standard ELISA.
Results: No significant difference could be established between the two groups regarding all hormones in the TP1. Cortisol levels did not differ at TP3 between the VDG and the CSG. The CSG presented with lower levels compared to the VDG (129.93 ± 63.10 vs 299.58 ± 74.00, P -value < 0.001) at TP2. IL-6 levels were lower in the CSG at TP2 (20.15 ± 7.25 vs 48.70 ± 7.45, P -value < 0.001) and higher at TP3 (21.85 ± 6.35 vs 6.86 ± 5.86, P -value < 0.001) compared to the VDG. IGF-1 levels were higher at TP2 in the CSG (230 ± 80.63 vs 173.15 ± 38.12, P -value = 0.004) in comparison to VDG, but were similar between the two groups at TP3 (101.38 ± 80.63 vs 88.19 ± 18.89, P -value = 0.94). Cortisol and IL-6 levels in the umbilical blood did not present with a statistically significant difference between the two groups. IGF-1 and GH levels in the umbilical blood were statistically significantly higher in the CSG.
Conclusion: Data presented indicate that CS is a less stressful procedure for mothers in comparison to VD, and is further associated with less intense inflammation with an albeit longer inflammatory response period. From the infants’ perspective, GH and IGF-1 appear to be increased in the umbilical cord blood of CS born neonates. Nonetheless, whether this may be attributed to mode of delivery remains unanswered.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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