Maternal Cytokine Balance on the Third Postpartum Day is Not Affected by the Mode of Delivery after Healthy Pregnancies

Abstract

Previous reports have suggested that delivery is associated with the induction of inflammatory cytokines. The present study was designed to investigate whether increased cytokine production was present on postpartum day 3 after a normal pregnancy and whether any changes were associated with the mode of delivery. In total, 33 pregnant women were enrolled; 18 delivered vaginally and 15 underwent an elective caesarean section (C-section). The levels of 17 cytokines and growth hormones were measured at the beginning of delivery or before anaesthesia and on postpartum day 3.

While interleukin (IL)-6 and IL-8 levels decreased significantly postpartum, other cytokine concentrations were comparable before and after delivery. Only IL-7 levels were significantly increased in the C-section patients compared with the vaginal birth patients postpartum. In conclusion, there was no risk of a prolonged maternal inflammatory reaction after an uncomplicated vaginal birth or elective C-section, so it is probably not necessary to consider this as an issue when making a decision on the mode of delivery following uncomplicated pregnancy.

Keywords

Pregnancy Mode of birth Maternal cytokine levels Postpartum

References

Malamitsi-Puchner

Protonotariou

Boutsikou

: The influence of the mode of delivery on circulating cytokine concentrations in the perinatal period. Early Hum Dev 2005; 81: 387–392.

Sarandakou

Giannaki

Malamitsi-Puchner

: Inflammatory cytokines in newborn infants. Mediators Inflamm 1998; 7: 309–312.

Rizos

Protonotariou

Malamitsi-Puchner

: Cytokine concentrations during the first days of life. Eur J Obstet Gynecol Reprod Biol 2007; 131: 32–35.

Bakheit

Bayoumi

Adam

: Peripheral, placental and cord cytokines profile in spontaneous labor and elective caesarean section. Iran J Immunol 2008; 5: 185–188.

Buonocore

De Filippo

Gioia

: Maternal and neonatal plasma cytokine levels in relation to mode of delivery. Biol Neonate 1995; 68: 104–110.

Chiesa

Signore

Assumma

: Serial measurements of C-reactive protein and interleukin-6 in the immediate postnatal period: Reference intervals and analysis of maternal and perinatal confounders. Clin Chem 2001; 47: 1016–1022.

Park

Lockwood

: Role of cytokines in preterm labor and birth. Minerva Ginecol 2005; 57: 349–366.

Romero

Gotsch

Pineles

: Inflammation in pregnancy: Its roles in reproductive physiology, obstetrical complications, and fetal injury. Nutr Rev 2007; 65: S194–S202.

Blank

Hirsch

Challis

: Cytokine signaling, inflammation, innate immunity and preterm labour–a workshop report. Placenta 2008; 29 (suppl A): S102–S104.

10.

De Jongh

Bosmans

Puylaert

: The influence of anaesthetic techniques and type of delivery on peripartum serum interleukin-6 concentrations. Acta Anaesthesiol Scand 1997; 41: 853–860.

11.

Kovar

Riches

: C3 and C4 complement components and acute phase proteins in late pregnancy and parturition. J Clin Pathol 1988; 41: 650–652.

12.

Remick

: Interleukin-8. Crit Care Med 2005; 33 (12 suppl): S466–S467.

13.

Keski-Nisula

Kirkinen

Ollikainen

: C-reactive protein in uncomplicated parturients delivered by cesarean section. Acta Obstet Gynecol Scand 1997; 76: 862–867.

14.

Jiang

Aiello

: Cell biology of IL-7, a key lymphotrophin. Cytokine Growth Factor Rev 2005; 16: 513–533.

15.

Gustafsson

Hummerdal

Matthiesen

: Cytokine secretion in decidual mononuclear cells from term human pregnancy with or without labour: ELISPOT detection of IFN-γ, IL-4, IL-10, TGF-β and TNF-α. J Reprod Immunol 2006; 71: 41–56.

16.

Carvalho

Clark

Angst

: Local and systemic release of cytokines, nerve growth factor, prostaglandin E2, and substance P in incisional wounds and serum following cesarean delivery. J Pain 2008; 9: 650–657.