Abstract
To evaluate obstetric predictors of umbilical blood arginine vasopressin (AVP) levels and the timing of first voiding, 87 singleton term newborns were delineated into three groups: group A, vaginal delivery (N=30), group B, cesarean section (CS) during labor (N=26) and group C, elective CS (N=31). 26 (87%) mothers in group A and 21(81%) in group B received labor pain relief. Four (15%) group B mothers received epidural analgesia and spinal anesthesia, 13 (50%) spinal and 9 epidural anesthesia. In the group C 30 (97%) received spinal and 1 epidural anesthesia. Labor pain was evaluated with a visual analog scale (VAS, range 0–5). Data on the infants' health and time of the first voiding was recorded.
Results: 70% of group A and 86 % of group B mothers experienced adequate pain relief. The median (range) intensity of pain in the groups A and B were 3.40 (0.90–4.90) and 3.68 (0–4.95) (NS). The median (range) AVP concentration (ng/L) was 120 (0.7–2170) in the group A, 1.8 (0.01–183) in the group B and 0.8 (0.01–30) in the group C (p<0.05), having a positive correlation with duration of labor (p>0.001), time from membrane rupture (p=0.002), umbilical cord length (p=0.002) and gestational age (p=0.025) and a negative correlation with umbilical arterial pH (p=0.007) and mothers' blood loss (p=0.001). The infants voided first time at median (range) age of 8.7 (0–38.9) hours in group A, 7.8 (0–31.0) in group B and 0.8 (0–16.5) in group C (p=0.017). The timing had a positive correlation with time from membrane rupture (p=0.037), gestational age (p=0.003), volume of formula feeding (p<0.001) and umbilical AVP concentration (p=0.023).
Conclusion: Maturity, labor and factors, dangerous to placental perfusion, seem to increase AVP secretion in the fetus and affect timing of the first voiding in the neonate. Labor induces mechanisms protecting circulation in the newborn.
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Hietanen, A., Laatta, J., Ojala, R. et al. 369 Can Obstetric Factors Predict Arginine Vasopressin Release and the Timing of First Voiding in the Newborn Infant?. Pediatr Res 58, 417 (2005). https://doi.org/10.1203/00006450-200508000-00398
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DOI: https://doi.org/10.1203/00006450-200508000-00398
