Cesarean delivery and infant cortisol regulation
Leticia D Martinez1, Laura M Glynn2, Curt A Sandman3
1Department of Psychology, University of Denver, Denver, CO, USA; Department of Educational, School, and Counseling Psychology, University of Missouri, Columbia, MO, USA.
Infants born via cesarean delivery show altered hypothalamic pituitary adrenal (HPA) axis function, with lower cortisol levels compared to vaginally born infants. This difference persists regardless of whether the cesarean was medically indicated or elective, suggesting a link to long-term health.
Area of Science:
- Endocrinology
- Developmental Pediatrics
- Reproductive Health
Background:
- Cesarean delivery rates are significantly higher than medically indicated, raising global health concerns.
- Cesarean birth is linked to increased risks of infant metabolic and immune dysfunction.
- The hypothalamic pituitary adrenal (HPA) axis is a potential pathway connecting cesarean birth to later health issues.
Purpose of the Study:
- To investigate the relationship between delivery mode and HPA axis function in 6-month-old infants.
- To determine if elective versus indicated cesarean delivery impacts infant cortisol profiles differently.
Main Methods:
- Salivary cortisol was measured in 136 infants (39 cesarean, 97 vaginal) at baseline and after a stressor (inoculation).
- Medical records were reviewed for prenatal history and birth outcomes.
- Cortisol levels were compared between delivery groups, including a subgroup analysis of elective cesareans.
Main Results:
- Infants delivered by cesarean exhibited lower baseline and post-stress cortisol concentrations than vaginally delivered infants.
- This association between delivery mode and cortisol levels remained significant even when comparing elective cesareans to vaginal births.
Conclusions:
- Cesarean delivery is associated with altered HPA axis function in infancy.
- Findings support the hypothesis that the HPA axis mediates the link between cesarean birth and long-term infant health outcomes.
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