Mode of Delivery Influences Nociceptive Sensitivity in Newborn Infants - the NociCop Trial
Severin Kasser, Dr. med. UKBB
mardi, 10 janvier 2017
The process of vaginal birth prepares the fetus for the extra-uterine environment and, in comparison to infants delivered by planned caesarean section (PCS), confers respiratory, cardiovascular and homeostatic advantages to the newborn. The effect of delivery mode and birth stress on noci- ception is largely unknown. The objective of this study was to examine noxious-evoked brain activity a few hours after birth in infants born by vaginal delivery (VD) as compared to PCS. Results: The average gestational age at the time of the study was 39 ± 0.91 weeks (mean ± SD). The magnitude of the evoked nociceptive-speci c brain activity was signi cantly higher in infants born by PCS 25 ± 1.3 μV (median ± SD) as compared to VD (18 ± 1.2, p<0.01). The evoked magnitude was positively cor- related with arterial cord blood pH (p=0.038) and negatively cor- related with copeptin (p=0.015). In a linear regression model with evoked magnitude as dependent variable and delivery mode, sex and parity as independent variables, boys had signi cantly higher nociceptive sensitivity than girls also after adjustment for gestational age at delivery. Conclusion: Birth experience shapes nociceptive sensitivity in newborn infants in a stress and sex-dependent fashion.