• S E Vogl, C Worda, C Egarter, C Bieglmayer, T Szekeres, J Huber, and P Husslein.
• Department of Obstetrics and Gynecology, Division of Obstetrics, University of Vienna Medical School, Vienna, Austria. sonja.vogl@meduniwien.ac.at
• BJOG. 2006 Apr 1;113(4):441-5.

ObjectiveTo determine whether mode of delivery is associated with the endocrine stress response in mother and child.DesignProspective observational study.SettingTertiary care centre, University hospital.PopulationA total of 103 nulliparous women with uncomplicated singleton pregnancies at term undergoing either spontaneous labour for vaginal delivery or delivering by caesarean section without labour. Thirty women delivered vaginally without any pain relief, 21 women delivered vaginally with epidural anaesthesia, 23 women had ventouse extraction and 29 women underwent caesarean section with epidural analgesia.MethodsAfter delivery, maternal and umbilical cord blood was collected for determination of different stress-associated hormones.Main Outcome MeasuresConcentrations of epinephrine (EP), norepinephrine (NOR), adrenocorticotropic hormone (ACTH), cortisol (CORT), prolactin (PRL), corticotropin-releasing factor and beta-endorphin (BE).ResultsCaesarean section was associated with significantly lower maternal concentrations of EP, NOR, ACTH, CORT, PRL and BE and lower newborn levels of EP, NOR and CORT compared with all other modes of delivery. Concentrations of EP, ACTH and BE differed significantly in newborns delivered by normal vaginal delivery, vaginal delivery with epidural anaesthesia and ventouse extraction.ConclusionsThe mode of delivery and analgesia used during birth are associated with maternal and fetal endocrine stress responses.

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