Effects of Prenatal Education and Type Of Delivery On Stress Axes

Abstract

Background: Training received during pregnancy may alter the prenatal stress level. The purpose of this study was to investigate the effects of prenatal education on the stress axis of the body, namely the hypothalamo- pituitary adrenal axis (HPA) and autonomic nervous system (ANS) in different delivery types (vaginal or caesarean section). Materials and Methods: In this prospective study, women who were going to have caesarean or vagi-nal delivery were compared in terms of whether they undertook prenatal education (PNE) in pregnan-cy school or not. Among those of women having PNE, twenty women had caesarean delivery and, therefore, the number of women in other groups was decided accordingly. As a result, a total of 4 groups were formed as follows: women having PNE/caesarean delivery (n=20), having PNE/vaginal delivery (n=20), not having PNE/having caesarean delivery (n=20) and not having PNE/having vaginal delivery (n=20). In these women, the prenatal HPA and ANS activities were measured non-invasively with saliva cortisol and heart rate variability (HRV), respectively. HRV was measured by 5-min electro-cardiogram recording and time- and frequency-domains parameters were calculated.Results: The (PNE) did not affect the prenatal cortisol and HRV parameters in none of the delivery types (vaginal and caesarean) (p>0.05). HRV parameters were higher in women having vaginal delivery than those of caesarean delivery (P<0.05). No correlations were observed between the cortisol and HRV parameters (P>0.05).Conclusion: The prenatal education had no effect on HPA and ANS; however, the delivery type altered the HRV parameters. Saliva cortisol and HRV may be useful parameters in terms of examining the phys-iology of the birth processKey Words: Cortisol, Heart rate variability, Prenatal education, Vaginal delivery, Caesarean delivery