Delivery Modality Affect Neonatal Levels of Inflammation, Stress, and Growth Factors
Introduction: As part of the study CODIBINE, Correlations and Diagnoses for Biomarkers in New-borns, the main objective of the study was to explore neonatal inflammation, stress, neurodevelopment, and growth factors after in-labor and pre-labor cesarean section compared to vaginal delivery. Increasi...
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doaj-53dc99e45c054a4190b7a5f1aff532012021-09-22T05:19:17ZengFrontiers Media S.A.Frontiers in Pediatrics2296-23602021-09-01910.3389/fped.2021.709765709765Delivery Modality Affect Neonatal Levels of Inflammation, Stress, and Growth FactorsPia Kiilerich0Rikke Cortes1Ulrik Lausten-Thomsen2Nis Borbye-Lorenzen3Solveig Holmgaard4Kristin Skogstrand5Department for Congenital Disorders, Danish Center for Neonatal Screening, Statens Serum Institute, Copenhagen, DenmarkDepartment for Congenital Disorders, Danish Center for Neonatal Screening, Statens Serum Institute, Copenhagen, DenmarkNeonatal Intensive Care Unit, Copenhagen University Hospital Rigshospitalet, Copenhagen, DenmarkDepartment for Congenital Disorders, Danish Center for Neonatal Screening, Statens Serum Institute, Copenhagen, DenmarkDepartment for Congenital Disorders, Danish Center for Neonatal Screening, Statens Serum Institute, Copenhagen, DenmarkDepartment for Congenital Disorders, Danish Center for Neonatal Screening, Statens Serum Institute, Copenhagen, DenmarkIntroduction: As part of the study CODIBINE, Correlations and Diagnoses for Biomarkers in New-borns, the main objective of the study was to explore neonatal inflammation, stress, neurodevelopment, and growth factors after in-labor and pre-labor cesarean section compared to vaginal delivery. Increasing evidence has shown that birth delivery mode has an impact on imminent and long-term child health. However, the effect of the timing of cesarean section is insufficiently elucidated. The main objective of the study was to explore the effect of different delivery modes, vaginal delivery compared to cesarean section with or without initiation of labor, on the infants.Methods: We designed a retrospective cohort study, including dried blood spot samples from mature (gestational age ≥ 37) newborns delivered in the years 2009-2011. The newborns were divided into three groups after delivery mode: (1) pre-labor cesarean section (n = 714), i.e., cesarean delivery without initiation of labor, (2) in-labor cesarean section (n = 655), i.e., cesarean section after initiation of labor, and (3) vaginal delivery (n = 5,897). We measured infant levels of inflammatory (IL-18, MCP-1, CRP, sTNF RI), stress (HSP-70), growth (EGF, VEGF-A), and neurotrophic factors (BDNF, NT-3, S100B) 2–4 days after birth.Results: The neonatal levels of inflammatory and stress markers were significantly lower, while the levels of growth factors were higher after pre-labor cesarean section compared to vaginal delivery. The biomarker levels were similar after in-labor cesarean section and vaginal delivery. Removing cases with pre-labor rupture of membranes and artificial rupture of membranes in the calculations did not change the results. The levels of neurotrophic factors were unaffected by delivery form. Males had generally higher levels of inflammation and lower levels of growth and neurotrophic factors. Overall, the levels of inflammatory markers increased, and the growth factors decreased with increasing gestational age.Conclusion: The present study of the biomarker levels after birth suggests that the labor process has an important effect on the fetal immune system and level of stress, regardless if the delivery ends with cesarean section or vaginal birth.https://www.frontiersin.org/articles/10.3389/fped.2021.709765/fullinflammationneonatal stressCODIBINEin-labor cesarean sectionpre-labor cesarean sectionlabor process |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Pia Kiilerich Rikke Cortes Ulrik Lausten-Thomsen Nis Borbye-Lorenzen Solveig Holmgaard Kristin Skogstrand |
spellingShingle |
Pia Kiilerich Rikke Cortes Ulrik Lausten-Thomsen Nis Borbye-Lorenzen Solveig Holmgaard Kristin Skogstrand Delivery Modality Affect Neonatal Levels of Inflammation, Stress, and Growth Factors Frontiers in Pediatrics inflammation neonatal stress CODIBINE in-labor cesarean section pre-labor cesarean section labor process |
author_facet |
Pia Kiilerich Rikke Cortes Ulrik Lausten-Thomsen Nis Borbye-Lorenzen Solveig Holmgaard Kristin Skogstrand |
author_sort |
Pia Kiilerich |
title |
Delivery Modality Affect Neonatal Levels of Inflammation, Stress, and Growth Factors |
title_short |
Delivery Modality Affect Neonatal Levels of Inflammation, Stress, and Growth Factors |
title_full |
Delivery Modality Affect Neonatal Levels of Inflammation, Stress, and Growth Factors |
title_fullStr |
Delivery Modality Affect Neonatal Levels of Inflammation, Stress, and Growth Factors |
title_full_unstemmed |
Delivery Modality Affect Neonatal Levels of Inflammation, Stress, and Growth Factors |
title_sort |
delivery modality affect neonatal levels of inflammation, stress, and growth factors |
publisher |
Frontiers Media S.A. |
series |
Frontiers in Pediatrics |
issn |
2296-2360 |
publishDate |
2021-09-01 |
description |
Introduction: As part of the study CODIBINE, Correlations and Diagnoses for Biomarkers in New-borns, the main objective of the study was to explore neonatal inflammation, stress, neurodevelopment, and growth factors after in-labor and pre-labor cesarean section compared to vaginal delivery. Increasing evidence has shown that birth delivery mode has an impact on imminent and long-term child health. However, the effect of the timing of cesarean section is insufficiently elucidated. The main objective of the study was to explore the effect of different delivery modes, vaginal delivery compared to cesarean section with or without initiation of labor, on the infants.Methods: We designed a retrospective cohort study, including dried blood spot samples from mature (gestational age ≥ 37) newborns delivered in the years 2009-2011. The newborns were divided into three groups after delivery mode: (1) pre-labor cesarean section (n = 714), i.e., cesarean delivery without initiation of labor, (2) in-labor cesarean section (n = 655), i.e., cesarean section after initiation of labor, and (3) vaginal delivery (n = 5,897). We measured infant levels of inflammatory (IL-18, MCP-1, CRP, sTNF RI), stress (HSP-70), growth (EGF, VEGF-A), and neurotrophic factors (BDNF, NT-3, S100B) 2–4 days after birth.Results: The neonatal levels of inflammatory and stress markers were significantly lower, while the levels of growth factors were higher after pre-labor cesarean section compared to vaginal delivery. The biomarker levels were similar after in-labor cesarean section and vaginal delivery. Removing cases with pre-labor rupture of membranes and artificial rupture of membranes in the calculations did not change the results. The levels of neurotrophic factors were unaffected by delivery form. Males had generally higher levels of inflammation and lower levels of growth and neurotrophic factors. Overall, the levels of inflammatory markers increased, and the growth factors decreased with increasing gestational age.Conclusion: The present study of the biomarker levels after birth suggests that the labor process has an important effect on the fetal immune system and level of stress, regardless if the delivery ends with cesarean section or vaginal birth. |
topic |
inflammation neonatal stress CODIBINE in-labor cesarean section pre-labor cesarean section labor process |
url |
https://www.frontiersin.org/articles/10.3389/fped.2021.709765/full |
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