Evidence map›Paper›PMID 33080520›Full record

ArticlePsychoneuroendocrinology2020

Cesarean delivery and infant cortisol regulation.

Leticia D Martinez, Laura M Glynn, Curt A Sandman, Deborah A Wing, Elysia Poggi Davis

Open access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Psychoneuroendocrinology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
15citing papers in PubMed, 2 pooled it
2.0field-weighted citation impact, top 10% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

15 citing papers in PubMed, 2 syntheses or guidelines pooled it, 34 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 3 institutions in 1 country.

Leticia D MartinezDepartment of Psychology, University of Denver, Denver, CO, USA; Department of Educational, School, and Counseling Psychology, University of Missouri, Columbia, MO, USA.
Laura M GlynnDepartment of Psychology, Chapman University, Orange, CA, USA.
Curt A SandmanDepartment of Psychiatry and Human Behavior, University of California, Irvine, Irvine, CA, USA.
Deborah A WingDepartment of Obstetrics and Gynecology, University of California, Irvine, Irvine, CA United States.
Elysia Poggi DavisDepartment of Psychology, University of Denver, Denver, CO, USA; Department of Psychiatry and Human Behavior, University of California, Irvine, Irvine, CA, USA. Electronic address: Elysia.Davis@du.edu.
University of California, Irvine · USChapman University · USUniversity of Missouri · US

Funding

Reducing Fetal Exposure to Maternal Depression to Improve Infant Risk MechanismsR01MH109662 · NIMH · UNIVERSITY OF DENVER (COLORADO SEMINARY) · PI DAVIS, ELYSIA POGGI, HANKIN, BENJAMIN L · 2017 to 2021
$4.0M
Fetal Programming of Early DevelopmentR01HD051852 · NICHD · UNIVERSITY OF CALIFORNIA-IRVINE · PI SANDMAN, CURT ALAN · 2006 to 2010
$2.7M
Vulnerability to Prenatal Glucocorticoids Programs Infant DevelopmentR01HD065823 · NICHD · UNIVERSITY OF CALIFORNIA-IRVINE · PI DAVIS, ELYSIA POGGI · 2010 to 2014
$2.4M
NICHD NIH HHS R01 HD051852NICHD NIH HHS R01 HD065823NIMH NIH HHS R01 MH109662
6 · The paper itself

Abstract

backgroundCesarean delivery reduces the risk of infant and maternal morbidity and mortality when medically indicated, however, the cesarean delivery rate is estimated to be two to three times higher than medically necessary. The World Health Organization and American College of Obstetricians and Gynecologists have expressed concern over the high rates of cesarean delivery, citing evidence that cesarean delivery has negative short- and long-term consequences for the health of the infant, mother, and for future pregnancies. Infants delivered by cesarean are at an increased risk of metabolic disease and immune dysfunction throughout the lifespan. Preliminary research suggests that the hypothalamic pituitary adrenal (HPA) axis is a plausible pathway linking cesarean delivery to poor health later in life. The present study examines the relation between mode of delivery and HPA axis function in six-month-old infants. We also examine whether the cesarean delivery was elective or indicated altered to the relation between mode of delivery and infant cortisol profiles.

methodsThe sample included 136 mother/infant pairs. Thirty-nine women delivered by cesarean and 97 delivered vaginally. Maternal and infant medical records were reviewed for prenatal medical history and birth outcomes. Infant saliva was collected for cortisol analysis at a 6-month well-baby checkup. Samples were collected upon arrival to the appointment (baseline) and 20 min after exposure to a painful stressor, the inoculation procedure (response). A mixed model ANCOVA was conducted to determine whether salivary cortisol concentrations differed between the two delivery groups. To examine whether complications related to having an indicated cesarean delivery contributed to any association between mode of delivery and cortisol production, cortisol concentrations were compared between the subgroup of infants whose cesarean deliveries were elective (e.g. maternal request or previous cesarean delivery) to infants delivered vaginally.

resultsInfants delivered by cesarean had lower cortisol concentrations at baseline and after the inoculation procedure compared to those delivered vaginally. Further, the relation between mode of delivery and cortisol levels persisted even when the analyses were restricted to compare only the elective cesarean deliveries (e.g. maternal request or previous cesarean delivery) to those delivered vaginally. DISCUSSION: This study provides evidence for an association between cesarean delivery and infant HPA axis function in infancy. Findings are consistent with the hypothesis that the HPA axis is a plausible pathway that links cesarean delivery with long-term health outcomes.

Indexed as

AdultCesarean SectionFemaleHumansHydrocortisoneHypothalamo-Hypophyseal SystemInfantInfant, NewbornMothersPituitary-Adrenal SystemPregnancyPregnancy ComplicationsSalivaStress, PsychologicalHydrocortisoneCesarean deliveryCortisolDelivery modeHPA axisStress

Identifiers

PMID33080520
PMCPMC7818649
OpenAlexW3090181103

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.