Effects of Prenatal Education and Type Of Delivery On Stress Axes

Abstract

Background: Training received during pregnancy may alter the prenatal stress level. The purpose of this study was to investigate the effects of prenatal education on the stress axis of the body, namely the hypothalamo- pituitary adrenal axis (HPA) and autonomic nervous system (ANS) in different delivery types (vaginal or caesarean section).
Materials and Methods: In this prospective study, women who were going to have caesarean or vagi-nal delivery were compared in terms of whether they undertook prenatal education (PNE) in pregnan-cy school or not. Among those of women having PNE, twenty women had caesarean delivery and, therefore, the number of women in other groups was decided accordingly. As a result, a total of 4 groups were formed as follows: women having PNE/caesarean delivery (n=20), having PNE/vaginal delivery (n=20), not having PNE/having caesarean delivery (n=20) and not having PNE/having vaginal delivery (n=20). In these women, the prenatal HPA and ANS activities were measured non-invasively with saliva cortisol and heart rate variability (HRV), respectively. HRV was measured by 5-min electro-cardiogram recording and time- and frequency-domains parameters were calculated.
Results: The (PNE) did not affect the prenatal cortisol and HRV parameters in none of the delivery types (vaginal and caesarean) (p>0.05). HRV parameters were higher in women having vaginal delivery than those of caesarean delivery (P<0.05). No correlations were observed between the cortisol and HRV parameters (P>0.05).
Conclusion: The prenatal education had no effect on HPA and ANS; however, the delivery type altered the HRV parameters. Saliva cortisol and HRV may be useful parameters in terms of examining the phys-iology of the birth process

Key Words: Cortisol, Heart rate variability, Prenatal education, Vaginal delivery, Caesarean delivery

Keywords

• cortisol
• heart rate variability
• prenatal education
• vaginal delivery
• caesarean delivery

Stres Aksı Üzerine Doğum Tipi ve Prenatal Eğitimin Etkileri

Abstract

Amaç: Gebelik döneminde alınan eğitim doğum öncesi stres seviyesini değiştirebilir. Bu çalışmanın amacı, prenatal eğitimin farklı doğum tiplerinde (vajinal veya sezaryen), vücudun stres aksı üzerine yani hipotalomo-hipofiz adrenal aks (HPA) ve otonom sinir sistemi (ANS) üzerindeki etkilerini araştırmaktı.
Materyal ve Metod: Bu prospektif çalışmada sezaryen veya vajinal doğum yapacak kadınlar gebelik okulunda doğum öncesi eğitim (PNE) alıp almamaları açısından karşılaştırıldı. PNE'si olan kadınlardan yirmisi sezaryen ile doğum yapmış ve bu nedenle diğer gruplardaki kadın sayısı buna göre kararlaştırılmıştır. Sonuç olarak toplam 4 grup şu şekilde oluştu: PNE/sezaryen doğum yapanlar (n=20), PNE/vajinal doğum yapanlar (n=20), prenatal eğitim almayan/sezaryen doğum yapanlar (n=20) ve pre-natal eğitim almayan/vajinal doğum yapanlar (n=20). Bu kadınlarda doğum öncesi HPA ve ANS ak-tiviteleri, sırasıyla tükürük kortizolü ve kalp hızı değişkenliği (HRV) ile non invazif ölçüldü. HRV, 5 dakikalık elektrokardiyogram kaydı ile ölçüldü ve zaman-bağımlı ve frekans bağımlı parametreler hesaplandı.
Bulgular: Prenatal eğitim (PNE) her iki doğum tipinde (vajinal ve sezaryen) doğum öncesi kortizol ve HRV parametrelerini etkilememiştir (p>0.05). HRV parametreleri vajinal doğum yapanlarda sezaryen doğum yapanlardan daha yüksekti (p<0.05). Kortizol ve HRV parametreleri arasında herhangi bir korela-syon gözlenmedi (p>0.05).
Sonuç: Prenatal eğitimin HPA ve ANS etkisi olmamıştır fakat doğum tipi HRV parametrelerini değiştirmiştir. Tükürük kortizolü ve HRV, doğum sürecinin fizyolojisini incelemek açısından yararlı para-metreler olabilir.

Anahtar kelimeler: Kortizol, Kalp hızı değişkenliği, Prenatal eğitim, Vajinal doğum, Sezaryen doğum

Keywords

• kortizol
• kalp hızı değişkenliği
• prenatal eğitim
• vajinal doğum
• sezaryen doğum

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