Do cesarean delivery's effects on birth hormones impact a ne
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Little is known about how delivery by C-section affects an individual's long-term development. As these interventions become more common in health care to foster positive outcomes for both mothers and babies, it is important to understand these long-term effects, both positive and negative, according to William Kenkel, an assistant professor of psychological and brain sciences at the University of Delaware. Specifically, Kenkel is interested in understanding how different birth experiences, including vaginal delivery, emergency C-section and scheduled C-section, affect the developing nervous system. He also wants to know whether these changes occur through hormones that surge during birth.

"The body is set up in very redundant ways, and it reuses the same set of hormones for multiple things," said Kenkel, who studies the way hormones affect the brain to shape behavior.

Looking across the research literature, however, Kenkel found that how one is born can have an effect on the amount of stress hormones released at the time of delivery. For example, vaginal delivery had the highest presence of birth signaling hormones, followed by emergency cesarean, then scheduled cesarean with the lowest levels. He pointed out, too, that when babies are delivered by cesarean section, some of these normal hormonal signals are disrupted, or, in the case of scheduled C-section, never even started. How long these hormonal differences last remains unknown. This led Kenkel to question whether research should be looking at this more closely because these hormones acting in early life are capable of developmental programming, meaning they can cause permanent changes.

"Most likely there is a very broad, but shallow effect occurring," said Kenkel, who is among only a handful of researchers considering the hormonal implications of birth and the brain.

Other research, particularly related to a healthy microbiome, has focused on whether procedures should be used to reintroduce microbes that babies delivered by cesarean may have missed out on. Kenkel wonders if the same idea could be used to introduce hormones in children that might not be activated by cesarean delivery. This is not necessarily a new idea. For example, premature infants are often given a hormone called cortisol to help the lungs mature. While a lot of research has looked at the hormone oxytocin and whether or not it could play a role in the causes of autism, according to Kenkel, cesarean delivery and obstetric interventions more broadly, are all things that affect oxytocin signaling during this sensitive period around birth. These hormones are versatile, too. Oxytocin is well known for its role in social bonding and helping mom bond with her baby, but evolution has found a lot of other uses for it. Oxytocin is also really good at regulating appetite, temperature and stress response.

If he can establish that hormones during birth play a long-lasting role in life, Kenkel said, it would lend evidence for research to explore possible interventions that could be applied at birth to ensure development that more closely resembles outcomes associated with a vaginal delivery. Kenkel published his findings in a paper in the Journal of Neuroendocrinology. "At this stage of our understanding, we just need a lot more information," Kenkel said.

Source:https://onlinelibrary.wiley.com/doi/10.1111/jne.12912, MedicalXpress
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