The impact of physiological peripartal stress on the lifelong health of newborn

Abstract

In the last decades the exponential increase in frequency of Caesarean sections is being observed. At the same time, there is growing amount of epidemiologic data showing higher lifetime risk of incidence of several diseases in offspring who do not experience natural labour. These findings lead to investigation of mechanisms which are responsible for maladaptation of several organ systems. Authors of this article describe these mechanisms, focusing especially on epigenetic programming, production of microbiome and positive effect of peripartal stress on successful beginning of extrauterine life. The best prevention strategy is following the strict indications of elective Caesarean sections. The current trend worldwide is to prepare the chronically ill patient for vaginal birth instead of indicating elective Caesarean section. From obstetric point of view it is possible to offer the external version of the foetus in breech presentation, the possibility of vaginal birth after Caesarean section and leave out controversial indications. The inevitable elective Caesarean sections should be planned close to term or after the beginning of spontaneous labour. The composition of intestinal microbiome could be partially influenced by application of vaginal secretion on newborn born by Caesarean section but there is not enough data proving long term positive outcomes.