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Delivery Routes and Anesthesia Affect Cord Blood NGF, BDNF, and Neonatal Outcomes
Şükran Doğru1, Huriye Ezveci2, Fikriye Karanfil Yaman2
1Division of Perinatology, Department of Obstetrics and Gynecology, Konya City Hospital, Konya, Turkey.
Objective:
This study aimed to investigate the effects of delivery mode and anesthesia type on fetal cord blood levels of nerve growth factor (NGF) and brain-derived neurotrophic factor (BDNF), which are neurotrophins involved in neuronal survival, differentiation, and stress adaptation during the perinatal period.
Materials Methods:
In this cross-sectional, prospective study conducted from December 2023 to May 2024 at a single tertiary center, pregnant women were categorized based on delivery mode-vaginal delivery (VD) or cesarean section (CS). The CS group was subdivided according to anesthesia type: spinal or general. Cord blood NGF, BDNF, pH levels, and neonatal clinical outcomes were evaluated. Pregnant women with comorbidities and those receiving prenatal medical induction were excluded.
Results:
The study included 150 pregnant women. Fifty of these patients had VD and 100 had CS. Sixty of the pregnant women who had a CS received spinal anesthesia, and 40 received general anesthesia. Cord blood NGF (54.20 ± 32.04 vs. 47.01 ± 27.28, p = 0.176) and BDNF (80.98 ± 41.94 vs. 70.08 ± 37.53, p = 0.123) values were not different in those who delivered with CS and VD. Cord blood NGF and BDNF values were higher in the spinal anesthesia group (p = 0.002, p = 0.003). The cord blood pH value was higher in the spinal anesthesia group than in the VD and general anesthesia groups (p = 0.004).
Conclusion:
Cord blood NGF and BDNF values were higher in the spinal anesthesia group. These findings support the hypothesis that regional anesthesia may be associated with reduced fetal stress and improved biochemical adaptation at birth.
