Abstract
Objective: The number of babies born by elective caesarean section (CS) has increased dramatically in the last years compared to vaginal delivery (VD). So far CS delivery was supposed to be the safest route of delivery. However, in neonates born by CS severe adaption problems with need to transfer to intensive care are observed frequently. Although it is known that CS results in significant changes the hormonal milieu, there are very few studies related to its metabolic consequences. Present work was therefore addressed to compare the metabolic profile of cord blood serum in newborns born by CS with those born by VD. Research design and methods: Cord blood was obtained after 83 deliveries by CS and 98 by VD from healthy women with normal OGTT at 26–27 weeks of gestation, accurate gestational age, singleton pregnancy, absence of foetal anomalies. Neonatal fat mass was derived from measurement of skinfolds. Results: Maternal age was slightly higher but pre-pregnancy BMI was similar while gestational age at delivery, birth weight and fat mass were lower in CS vs. VD. Cord blood serum glucose, triglycerides, glycerol, and nonesterified fatty acids, as well as total-saturated, monounsaturated and polyunsaturated fatty acid concentrations were lower but insulin and insulin/glucose ratio were higher in CS than in VD. These differences maintained after adjustment for maternal pre-pregnancy BMI gestational age at delivery, birth weight and fat mass of neonates. Conclusion: Lower circulating glucose and lipid levels in newborns born by CS could be related to the known delay in their post-partum surges in catabolic hormones, like catecholamines and cortisol which is further enhanced by hyperinsulinemia. These metabolic changes with lower available circulating substances might contribute to frequent postpartum problems observed in newborns born by CS without experience of labor.
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