Influence of the Mode of Delivery on Umbilical and Postnatal Plasma Levels of 7 Corticosteroids in the Newborn

Abstract

Cortisol plasma levels are higher in vaginal delivery than in cesarean section(CS). Do other corticosteroids differ accordingly and how long might such differences persist into the newborn period? Aldosterone(A), corticosterone(B), deoxycorticosterone(DOC), progesterone (P), 17-hydroxyprogesterone(170HP), cortisol(F) and cortisone(E) were simultaneously followed in a 250μl plasma sample from 7 term infants at 0,2,4,6,12,24h,4d and 7d after CS. In comparison with a matched group of 12 vag. delivered term infants, mean glucocorticoid (F,E,B) and precursor (170HP) levels were generally lower (l.3-3.8x) in maternal and cord plasma after CS, whereas mineralocorticoids (A,DOC) were equal or slightly (1.8 x) higher. This different behavior of gluco-and mineralocorticoids seems to persist after birth: F,E,B+ 170HP were lower in the CS-group until 6-12h with less fluctuating F and B levels in the first 24h. A and DOC, however, remained higher until day 7 with maximum differences at 2 and 12h. The observed changes are most probably due to differences in partal stress and maternal fluid and electrolyte balance. (Approved by parents and ethical committee)

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