Study of the effect of early skin to skin contact on salivary cortisol as a biomarker of stress in full term neonates delivered by cesarean section

الملخص EN

Background: The transition from fetal to neonatal life is one of the most important causes of stress to the infant.

When the infant attempts to cope with a stressful situation, the developing hypothalamic- pituitary- adrenal axis is activated, culminating in alterations of cortisol level.

Early Skin to skin contact (SSC) between mother and her baby thought to decrease the neonatal stress.

Salivary cortisol has been widely used as biomarker of hypothalamic pituitary adrenal (HPA) axis activity.

Aim of the work: Our aim is to evaluate the effect of early skin to skin contact on salivary cortisol as a biomarker of stress in full term neonates.

Methods: This case control study was conducted on 40 full term neonates with gestational age 37- 42 weeks.

They were divided into two groups, the study group (n= 20) with initiation of SSC before 1st breast feeding and the control group (n= 20) with no initiation of SSC before the first breast feeding.

Samples were collected from infants after delivery in both groups (The basal measurement) and Ihour after first feed.

Results: The control group revealed a significant increase of salivary cortisol level from a mean of 24.2 ng/dl in the basal measurement to a mean of 33.4 ng/dl in the 1 hour after 1st feed measurement.

In contrast, It increased slightly from a mean of 22.7 ng/dl in the basal measurement to a mean of 23.1 ng/dl 1 hour after 1st feed in the study group and this increase was not statistically significant.

Cortisol level didn’t statistically correlate with gestational age, maternal age or birth weight.

In contrast, Heart rate and Apgar score have statistically significant correlation with it.

Conclusions: Early skin to skin contact is recommended after birth as the increase in salivary cortisol level (which is a biomarker of stress) was not statistically significant indicating less exposure to stress.