Birth experience in newborn infants is associated with changes in nociceptive sensitivity

Severin Kasser,Sven Wellmann,Maria M Cobo,Noemi Klarer,Sezgi Goksan,Gabrielle Green,Hanna Rickenbacher,Caroline Hartley,Walter Magerl,Evelyn A Huhn,Antoinette Depoorter,Rebeccah Slater,Amy Hoskin,Alexandre N Datta

doi:10.1038/s41598-019-40650-2

Abstract

Vaginal birth prepares the fetus for postnatal life. It confers respiratory, cardiovascular and homeostatic advantages to the newborn infant compared with elective cesarean section, and is reported to provide neonatal analgesia. We hypothesize that infants born by vaginal delivery will show lower noxious-evoked brain activity a few hours after birth compared to those born by elective cesarean section. In the first few hours of neonatal life, we record electrophysiological measures of noxious-evoked brain activity following the application of a mildly noxious experimental stimulus in 41 infants born by either vaginal delivery or by elective cesarean section. We demonstrate that noxious-evoked brain activity is related to the mode of delivery and significantly lower in infants born by vaginal delivery compared with those born by elective cesarean section. Furthermore, we found that the magnitude of noxious-evoked brain activity is inversely correlated with fetal copeptin production, a surrogate marker of vasopressin, and dependent on the experience of birth-related distress. This suggests that nociceptive sensitivity in the first few hours of postnatal life is influenced by birth experience and endogenous hormonal production.

Highlights

Vaginal birth prepares the fetus for postnatal life
Noxious-evoked brain activity was significantly higher in infants born by elective cesarean section (n = 19) compared with infants born by vaginal delivery (n = 22, Fig. 1C, p = 0.008, regression coefficient β = 0.088, 95% CI: [0.025, 0.15])
The process of vaginal birth prepares the fetus for the extra-uterine environment; it confers respiratory, cardiovascular and homeostatic advantages to the newborn infant[15,16], and is considered to play a critical role in breastfeeding and infant-mother bonding[17,18]

Summary

Introduction

Vaginal birth prepares the fetus for postnatal life. It confers respiratory, cardiovascular and homeostatic advantages to the newborn infant compared with elective cesarean section, and is reported to provide neonatal analgesia. We found that the magnitude of noxious-evoked brain activity is inversely correlated with fetal copeptin production, a surrogate marker of vasopressin, and dependent on the experience of birth-related distress. This suggests that nociceptive sensitivity in the first few hours of postnatal life is influenced by birth experience and endogenous hormonal production. 5 μV 200 ms Delivery Mode blood is approximately 100 times higher in healthy infants born by vaginal delivery compared to those delivered by elective cesarean section[12] This leads to the possibility that birth-related stress drives an increase in fetal vasopressin production which leads to endogenous analgesia being conferred to the newborn infant

Methods

Results

Conclusion