Stress of delivery results in marked elevations of catecholamine levels and activates fetal gluconeogenesis.
We examined by ABL90 FLEX Radiometer analyzer (Copenhagen, Denmark) glucose and acidemia levels in umbilical artery blood at birth in 341 spontaneous and 25 vacuum extractor at term vaginal deliveries (VD) and in 85 elective and 49 emergency of term caesarean sections (CS), respectively performed at the Policlinico Abano Terme (Abano Terme, Italy) from January to June 2013.
The mean (±SD) average neonatal blood glucose at birth was 95.0 (±20.6) mg% in the spontaneous VD group, 101.4 (±30.6) mg% in the vacuum extractor VD group, 69.9 (±13.8) mg% in the elective CS group and 85.4 (±16.1) mg% in the emergency CS group. The VD by vacuum extractor group had significantly increased neonatal cord blood glucose values (p < 0.001) and a significantly lower cord blood pH than the other groups (p < 0.001). Conversely, the elective CS group showed significantly reduced neonatal cord blood glucose values (p = 0.004) and significantly higher cord blood pH than the other groups (p < 0.001). In addition, glucose levels in the total population and in the VD by vacuum extractor group were significantly negatively correlated with pH (r = -0.094, p = 0.036 and r = -0.594, p = 0.007, respectively).
In conclusion, the stress of labour increases both umbilical cord blood glucose and acidemia levels in term neonates.