Abstract
There is good evidence from animal data that exposure to high levels of cortisol in the perinatal period can result in permanent long-term programming of the hypothalamic–pituitary–adrenal (HPA) response. Our hypothesis is that cortisol levels measured in cord blood, which vary by type of delivery, may influence long-term HPA responses. Arterial cord-blood was collected within 20 minutes of delivery from consenting primiparous women who were delivered normally, or by assisted delivery, elective or emergency caesarean section. At 2 months of age infant salivary cortisol was measured, both at baseline and 20 minutes after the stressor of routine vaccination. There was a significant difference in cord artery cortisol at birth between the four delivery groups analysed (one-way anova, P < 0.0001). All vaginal deliveries vs. all caesarean deliveries were significantly different in mean values (596 nmol/l ± 219 vs. 377 ± 163, respectively, n = 130, t-test P < 0.001) The rise in cortisol at 2 months after vaccination correlated linearly with birth cortisol levels (r = 0.321, n = 50, P < 0.05).
Published Version
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