Phenomenon of neonatal adaptation: progesterone, ACTH and cortisol during the 1st 24 hours of life
Bagnoli, F.; Bruchi, S.; Garosi, G.; Caniggia, I.; Inaudi, P.A.
Bollettino della Societa Italiana di Biologia Sperimentale 64(4): 317-322
1988
ISSN/ISBN: 0037-8771 PMID: 2847766 Document Number: 315998
The authors examined 53 full-term newborns divided into 4 groups according to the mode of delivery: I) newborns from spontaneous delivery (SD); II) newborns from elective cesarean section without labor (ECS); III) newborns from elective cesarean section at established labor (ECSL); IV) newborns from emergency cesarean section (EMCS) performed for fetal distress demonstrated by meconium stained amniotic fluid and/or alterations of fetal heart rate in cardiotocography. In cord blood and in blood collected at the 24th hour of life, plasma levels of progesterone (P), cortisol (F) and ACTH were measured by RIA. In cord blood, plasma P levels were higher in EMCS than in SD and ECS (P < 0.02) and ECSL (P < 0.05); the highest F concentrations were measured in EMCS while in SD they were significantly higher than in ECS and ECSL (P < 0.001); plasma ACTH levels were similar in newborns from SD and EMCS and in both these groups they were significantly higher than in ECS (P < 0.05). At the 24th hour, plasma P levels significantly decreased in all 4 groups (P < 0.001) while plasma ACTH concentrations did not vary; F levels increased in newborns from ECS (P < 0.05) while decreased in the other 3 groups (SD P < 0.02). The results suggest that fetal distress causes elevated levels of P, F and ACTH in cord blood, while in newborns from ECS the lack of stress is followed by low concentrations of these hormones. The increase in F levels at the 24th hour only in newborns from ECS and the stable concentration of ACTH demonstrate a different neonatal metabolic adaptation between newborns from ECS and the other 3 groups, probably due to lack of labor.