Stress responses at birth: Determinants of cord arterial cortisol and links with cortisol response in infancy

Miller, N. M., Fisk, N. M., Modi, N. and Glover, V. (2005) Stress responses at birth: Determinants of cord arterial cortisol and links with cortisol response in infancy. BJOG: An International Journal of Obstetrics & Gynaecology, 112 7: 921-926. doi:10.1111/j.1471-0528.2005.00620.x


Author Miller, N. M.
Fisk, N. M.
Modi, N.
Glover, V.
Title Stress responses at birth: Determinants of cord arterial cortisol and links with cortisol response in infancy
Journal name BJOG: An International Journal of Obstetrics & Gynaecology   Check publisher's open access policy
ISSN 1470-0328
0140-7686
1471-0528
Publication date 2005-07-01
Year available 2005
Sub-type Article (original research)
DOI 10.1111/j.1471-0528.2005.00620.x
Open Access Status DOI
Volume 112
Issue 7
Start page 921
End page 926
Total pages 6
Place of publication London, U.K.
Publisher Blackwell
Language eng
Subject 111402 Obstetrics and Gynaecology
1114 Paediatrics and Reproductive Medicine
Abstract Objective To investigate (A) the determinants of infant stress response at delivery and (B) test the hypothesis that stress at birth, as reflected by cord arterial cortisol, influences cortisol response to vaccination at two months.
Formatted abstract
Objective: To investigate (A) the determinants of infant stress response at delivery and (B) test the hypothesis that stress at birth, as reflected by cord arterial cortisol, influences cortisol response to vaccination at two months.
Design: Prospective observational study.
Setting: Tertiary referral maternity hospital.
Population: One hundred and seventy-two primiparous women with uncomplicated singleton pregnancies.
Methods: Women were recruited antenatally. At birth, cord arterial blood and obstetric data were collected. Saliva was collected from infants immediately before and after vaccination at two months. Cortisol was analysed from cord blood and saliva by radio-immunoassay.
Main outcome measures: Stress response at birth, as demonstrated by cord arterial cortisol; association with saliva cortisol response to vaccination at two months.
Results: Cord arterial cortisol varied with mode of delivery, combined spinal/epidural use and pH. Salivary cortisol response at two months correlated with cord arterial cortisol (r= 0.24, P < 0.05). Infants with the highest and lowest cord arterial cortisol had markedly different cortisol responses at two months (P= 0.017). These groups had different modes of delivery with caesarean rates of <8% in the high cortisol response group and 83% in the low cortisol response group (P < 0.0001).
Conclusion: Babies born vaginally mount greater cortisol responses at birth than those delivered by caesarean section. Stress at delivery may influence the infant HPA axis response for up to two months.
©RCOG 2005 BJOG: an International Journal of Obstetrics and Gynaecology

Keyword Infant stress response at delivery
Cord arterial cortisol
Q-Index Code C1
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Excellence in Research Australia (ERA) - Collection
School of Medicine Publications
 
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Created: Sat, 21 Mar 2009, 00:50:12 EST by Maria Campbell on behalf of Faculty Of Health Sciences