Neutrophil chemotaxis in infants delivered by caesarean section

Gasparoni, Antonella; Chirico, G; Amici, D. De; Marconi, Maurizio; Belloni, C; Mingrat, G.; Rondini, G

doi:10.1007/bf01958427

Cited by 16 publications

(10 citation statements)

References 7 publications

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“…Previous studies have shown an increase in the circulating cortisol concentration after active labor and vaginal delivery as opposed to cesarean section (17)(18)(19). The increase in cortisol secretion in vaginally delivered infants on day 7 was most likely the result of intense stress induced by parturition.…”

Section: Discussionmentioning

confidence: 88%

Pituitary-Adrenal Response in Preterm Very Low Birth Weight Infants after Treatment with Antenatal Corticosteroids

Ng¹,

Wong²,

Lam

et al. 1997

The Journal of Clinical Endocrinology & Metabolism

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Antenatal corticosteroids have been widely used for the prevention of respiratory distress syndrome in preterm neonates, yet little is known about their effects on the hypothalamic-pituitary-adrenal axis in these infants. We prospectively evaluated pituitary-adrenal function in 61 preterm (< 32 gestational weeks), very low birth weight (< 1500 g) infants on days 7 and 14 of life using the human CRH stimulation test. The baseline and poststimulation plasma ACTH and serum cortisol concentrations did not differ significantly between infants whose mothers received no antenatal corticosteroids, and those whose mothers received 1-2 doses or > 2 doses (mean 7.2 doses) of prenatal dexamethasone (P = > 0.12). The number of doses of dexamethasone and the time intervals between the last dose of drug and delivery did not significantly affect the pituitary-adrenal responsiveness on days 7 and 14 of life. Among infants who did not require mechanical ventilation at the time of the human CRH test, significantly higher plasma ACTH (P < 0.014) and lower serum cortisol concentrations (P < 0.02) were found on day 14 than on day 7. In contrast, none of the poststimulation hormone concentrations were significantly different in ventilated infants between days 7 and 14. The relationship between the blood hormone concentrations in each time epoch (day 7 and day 14) and possible confounding factors including gestational and postconceptional age, birth weight, sex, Apgar scores, mode of delivery, single or higher order births, and mode of ventilation were determined. Plasma ACTH concentrations on day 7 were found to be significantly higher in ventilated than in nonventilated infants (P = 0.006). However, none of the aforementioned factors correlated significantly with plasma ACTH concentrations on day 14. Serum cortisol concentrations on day 7 were significantly higher in infants of greater gestational age (P = 0.039) and birth weight (P = 0.013), with lower Apgar scores at 1 and 5 min (P = 0.021 and P = 0.049, respectively), and in those delivered vaginally (P = 0.047). Similarly, serum cortisol concentrations on day 14 were found to be significantly higher in infants with lower Apgar scores at 1 and 5 min (P = 0.011 and P = 0.014, respectively) and in infants requiring mechanical ventilation (P = 0.014). Our results suggest that single or multiple courses of antenatal dexamethasone have no long-lasting suppressive effects on pituitary-adrenal function in preterm, very low birth weight infants. Maturation of pituitary function appears to be more advanced than adrenal function. The organ's ability to respond appropriately to various stressful stimuli indicates that the pituitary-adrenal axis is highly responsive at these early gestational ages.

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Section: Discussionmentioning

confidence: 88%

Pituitary-Adrenal Response in Preterm Very Low Birth Weight Infants after Treatment with Antenatal Corticosteroids

Ng¹,

Wong²,

Lam

et al. 1997

The Journal of Clinical Endocrinology & Metabolism

View full text Add to dashboard Cite

show abstract

“…The labor preceding cesarean section was also reported to significantly affect leukocyte counts [2,3]. Furthermore, the mode of delivery may affect neutrophil function [2,9,10] or the distribution of lymphocyte subpopulations [3,11] or cytokine production [12,13]. These effects have been mainly related to endocrine-metabolic variations, particularly the increased cortisol and catecholamine secretion after stressful delivery, or, to a lesser extent, to anesthetic drugs given to the mother during general anesthesia for cesarean section.…”

Section: Discussionmentioning

confidence: 99%

Leukocyte Counts in Relation to the Method of Delivery during the First Five Days of Life

Chirico¹,

Gasparoni

Ciardelli

et al. 1999

Neonatology

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The goal of the present study was to evaluate total and differential leukocyte counts during the first 5 days of life in relation to the method of delivery. We included 203 healthy term infants; of these, 114 were born by vaginal delivery, and 89 by elective cesarean section. Total and differential leukocyte counts were evaluated at the following intervals: 0–6, 7–12, 13–24, 25–48, 49–72, 73–96, and 97–120 h after birth. The cord serum cortisol level was measured as an indicator of the degree of delivery-related stress. Mean leukocyte and neutrophil counts were higher in infants born by vaginal delivery in cord blood and up to 12 h of life. No significant differences were observed in the immature: total neutrophil ratios between the two groups of infants. The cord serum cortisol level was higher in vaginally delivered infants. A significant correlation was found between cortisol and leukocyte, neutrophil, or lymphocyte counts. The method of delivery produces significantly different total leukocyte and neutrophil counts during the first 12 h after birth; after this time, there appears to be no more variation of leukocyte counts during the first 5 days of life.

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“…However, our results on their own do not determine whether the lower expression of IFN and markers of the innate immune system in the CS piglets are the result of the increased lipid accumulation or a result of the birth process itself. Interestingly, CS has been shown to alter the activity of cell types associated with the innate immune system [46] and results in an increased risk of Type 1 diabetes [3] and asthma [6], also suggesting long-term changes in the immune system as a result of CS.…”

Section: Altered Immune Gene Expressionmentioning

confidence: 99%

Delivery by Caesarean section, rather than vaginal delivery, promotes hepatic steatosis in piglets

et al. 2009

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There has been a marked increase in the number of babies born by elective CS (Caesarean section). Following CS, the lack of normal stimuli that occur at birth alters the thermogeneic response, but any effects on hepatic metabolism have not been identified. In the present study, we compared the effect of delivery on hepatic metabolism in piglets, born either by CS or VD (vaginal delivery) and fed by TPN (total parenteral nutrition), by measuring lipid metabolism and enzyme activity coupled with metabolomic and genomic approaches. Hepatic lipid in the CS piglets at 7 days post-partum was in excess of 5 mg/g of liver consistent with hepatic steatosis, whereas in the VD piglets the amount of lipid was markedly lower (3 mg/g of liver) and below the threshold for a diagnosis of steatosis. Metabolomic analysis indicated that CS resulted in higher hepatic glycerol and lower glycerol phosphate dehydrogenase activity, suggesting that CS causes a decrease in hepatic gluconeogenesis from glycerol. CS also resulted in altered cholesterol handling and gene expression, despite the same dietary intake for 7 days post-partum. Furthermore, the CS piglets had a lower expression of interferon-responsive genes, but a higher expression of markers of immature hepatocytes. In conclusion, the results suggest that VD promotes normal liver maturation and hepatic metabolism, thereby reducing the accumulation of hepatic lipid.

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Neutrophil chemotaxis in infants delivered by caesarean section

Cited by 16 publications

References 7 publications

Pituitary-Adrenal Response in Preterm Very Low Birth Weight Infants after Treatment with Antenatal Corticosteroids

Pituitary-Adrenal Response in Preterm Very Low Birth Weight Infants after Treatment with Antenatal Corticosteroids

Leukocyte Counts in Relation to the Method of Delivery during the First Five Days of Life

Delivery by Caesarean section, rather than vaginal delivery, promotes hepatic steatosis in piglets

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