Plasma epinephrine, norepinephrine, and cortisol of multigravidas in pregnancy and labor and in umbilical cord arteries after delivery

Lederman, Regina P.; Lederman, Edward; Work, Bruce A.; McCann, Daisy S.

doi:10.3109/01674828909016678

Cited by 6 publications

(5 citation statements)

References 16 publications

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“…This coincides with the findings of Ledermann et al [22] who showed a significant rise in cortisol during delivery according to different phases of cervical dilatation. Although the correlation (both p !…”

Section: Discussionsupporting

confidence: 80%

“…In contrast to reports after epidural anesthesia, intramuscularly administered analgetics (50 mg pethidine hydrochloride) were not able to reduce the stress response measured by ACTH during labor in our collective. Similarly, in contrast to Lederman et al [22] who showed that multiparous women have lower cortisol levels than primiparous women, our data regarding parity did not reveal such a statistically significant difference when compared with either ACTH or cortisol.…”

Section: Discussioncontrasting

confidence: 56%

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Childbirth as a Biological Model for Stress?

Bergant

Kirchler²,

Heim³

et al. 1998

Gynecol Obstet Invest

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Objective: The aims of this investigation were to measure corticotropin-releasing hormone (CRH), corticotropin (ACTH) and cortisol before, during and after delivery searching for an endocrine intercorrelation of the hypothalamic-pituitary-adrenal (HPA) axis and to correlate these findings with obstetrical variables. Methods: Blood was sampled from 50 women with singleton pregnancies at term without uterine contractions, during delivery (after full cervical dilatation) and on the 4th postnatal day. Hormones were measured by radioimmunoassay (RIA). The correlation between obstetric variables, sociodemographic and endocrine data were evaluated using the Spearman rank coefficient. Group comparisons for continuous variables were calculated using the Mann-Whitney U test and Kruskal-Wallis test. Results: Maternal plasma ACTH and cortisol increased significantly during labor, declining toward the 4th postnatal day (p < 0.001) and showing a significant intercorrelation (p < 0.01). Compared to women without uterine contractions CRH rose during labor (p < 0.05) and decreased rapidly to the 4th postnatal day (p < 0.001). No correlations between CRH and ACTH or cortisol were observed. None of the obstetrical variables (parity, newborn’s weight, duration of delivery) revealed any significant correlation with ACTH. Analgetic medication (pethidine hydrochloride) was not able to influence the endocrine response to labor stress. Conclusions: Stressful experience during childbirth has an impact on endocrine response. However, this is not fully evident along the HPA axis in a simple biological model with monocausal dependencies. This ‘biological stress model’ is not sensitive enough to detect different childbirth conditions and the hormones in the maternal compartment have partially fetal (placental) origin.

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Section: Discussionsupporting

confidence: 80%

Section: Discussioncontrasting

confidence: 56%

Childbirth as a Biological Model for Stress?

Bergant

Kirchler²,

Heim³

et al. 1998

Gynecol Obstet Invest

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“…There is conflicting evidence regarding pregnancy-related changes in plasma catecholamines (i.e., epinephrine and norepinephrine); there are reports of no changes [41–43], and increasing [44, 45] or decreasing [46, 47] levels as pregnancy progresses. However, there is consistent evidence that plasma epinephrine and norepinephrine are elevated among pregnant women with preeclampsia or gestational hypertension as compared to pregnant women without these conditions [48, 49].…”

Section: Basal Physiological Adaptation During Pregnancymentioning

confidence: 99%

Physiological reactivity to psychological stress in human pregnancy: Current knowledge and future directions

Christian

2012

Progress in Neurobiology

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Cardiovascular and neuroendocrine reactivity to acute stress are important predictors of health outcomes in non-pregnant populations. Greater magnitude and duration of physiological responses have been associated with increased risk of hypertensive disorders and diabetes, greater susceptibility to infectious illnesses, suppression of cell-mediated immunity as well as risk for depression and anxiety disorders. Stress reactivity during pregnancy has unique implications for maternal health, birth outcomes, and fetal development. However, as compared to the larger literature, our understanding of the predictors and consequences of exaggerated stress reactivity in pregnancy is limited. This paper reviews the current state of this literature with an emphasis on gaps in knowledge and future directions.

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“…Several reports have revealed the relationship between labor pain intensity and dystocia, suggesting that obstructed labor rate is higher as labor pain increased, while pain relief makes labor go smoothly [10–12]. A correlation was shown of endogenous plasma epinephrine and cortisol levels with labor progression [13, 14]. Neumark J et al [15] have demonstrated that cortisol level significantly rises in women undergoing epidural analgesia, while decreases as epinephrine level declined after pain relief.…”

Section: Introductionmentioning

confidence: 99%

Effect of epidural analgesia in trial of labor after cesarean on maternal and neonatal outcomes in China: a multicenter, prospective cohort study

Sun

Yan

Yuan

et al. 2019

BMC Pregnancy Childbirth

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BackgroundThe trial of labor after cesarean section (TOLAC) is a relatively new technique in mainland of China, and epidural analgesia is one of the risk factors for uterine rupture. This study aimed to evaluate the effect of epidural analgesia on primary labor outcome [success rate of vaginal birth after cesarean (VBAC)], parturient complications and neonatal outcomes after TOLAC in Chinese multiparas based on a strictly uniform TOLAC indication, management and epidural protocol.MethodsA total of 423 multiparas undergoing TOLAC were enrolled in this study from January 2017 to February 2018. Multiparas were divided into two groups according to whether they received epidural analgesia (study group, N = 263) or not (control group, N = 160) during labor. Maternal delivery outcomes and neonatal characteristics were recorded and evaluated using univariate analysis, multivariable logistic regression and propensity score matching (PSM).ResultsThe success rate of VBAC was remarkably higher (85.55% vs. 69.38%, p < 0.01) in study group. Epidural analgesia significantly shortened initiating lactation period and declined Visual Analogue Score (VAS). It also showed more superiority in neonatal umbilical arterial blood pH value. After matching by PSM, multivariable logistic regression revealed that the correction of confounding factors including epidural analgesia, cervical Bishop score at admission and spontaneous onset of labor were still shown as promotion probability in study group (OR = 4.480, 1.360, and 10.188, respectively; 95%CI = 2.025–10.660, 1.113–1.673, and 2.875–48.418, respectively; p < 0.001, p = 0.003, and p < 0.001, respectively).ConclusionsEpidural analgesia could reduce labor pain, and no increased risk of postpartum bleeding or uterine rupture, as well as adverse effects in newborns were observed. The labor duration of multiparas was increased, but within acceptable range. In summary, epidural analgesia may be safe for both mother and neonate in the three studied hospitals.Trial registrationChineses Clinical Trial Register, ChiCTR-ONC-17010654. Registered February 16th, 2017.

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Plasma epinephrine, norepinephrine, and cortisol of multigravidas in pregnancy and labor and in umbilical cord arteries after delivery

Cited by 6 publications

References 16 publications

Childbirth as a Biological Model for Stress?

Childbirth as a Biological Model for Stress?

Physiological reactivity to psychological stress in human pregnancy: Current knowledge and future directions

Effect of epidural analgesia in trial of labor after cesarean on maternal and neonatal outcomes in China: a multicenter, prospective cohort study

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