Investigating the effect of delivery type in term healthy singleton pregnancies on interleukin-1 beta and tumor necrosis factor alpha levels in umbilical cord blood

Aim: Birth is a complex process mediated by physiological, biochemical, endocrinological and immunological events. The form of delivery is very important for the intestinal microflora of the newborn. Specific strains of the intestinal microflora have been shown to stimulate the production of anti-inflammatory cytokines. Cytokines, especially proinflammatory cytokines such as interleukin-1β, IL-6 and TNF-α, have very important roles during preterm and term delivery. Based on this information, the aim of this study was to investigate the effect of the type of delivery on the levels of TNFα and IL-1β in umbilical cord blood. Material and Method: The study included healthy pregnant women older than 18 years of age without any diseases who were hospitalisated for normal spontaneous vaginal delivery (control group, n=30) and caesarean section (n=30) in Celal Bayar University Obstetrics and Gynecology Department. TNFα and IL-1β blood values were determined in the neonatal umbilical cord blood with chemoliminescence method. In addition, hemogram, MPV and platelet values were recorded in the maternal serum. The mean values of the variables were compared by independent variables t test and categorical variables were compared by Chi-Square test. The P value less than 0.05 was considered significant. Results: The number of gestational days (p = 0.003) and the number of live births (p=0.006) in women who had spontaneous normal vaginal delivery, were higher than those who had cesarean delivery. The mean number of parity was higher in women with cesarean section (p = 0.009). Hemoglobin levels were found to be higher in women who had spontaneous normal vaginal delivery (p = 0.001). TNF-alpha levels were found to be significantly higher in newborns who were born by spontaneous normal vaginal delivery in compared to those who were born with cesarean delivery (p = 0.037), however no difference was found in IL-1 beta values (p = 0.802) between two groups. Conclusion: The findings of the study contribute to the literature by supporting the view that normal vaginal delivery is a form of inflammation that stimulates the newborn's and mother's immune system. The fact that all of the findings were consistent with the literature constitutes the strength of the study. Key Words:Spontaneous vaginal delivery, cesarean delivery, TNF-alpha, IL-1 beta