Effect of general and epidural anaesthesia on thyroid hormones and immunity in neonates

Background: The aim of this study was to verify if variations of thyroid hormones related to circumstances of delivery and mode of maternal anaesthesia can contribute to neonatal neutrophil respiratory burst and natural killer cell activity. Methods: We evaluated 10 infants born by vaginal delivery...

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Published in:Pediatric anesthesia 2002-01, Vol.12 (1), p.59-64
Main Authors: GASPARONI, A, CIARDELLI, L, DE AMICI, D, CASTELLAZZI, A. M, AUTELLI, M, BOTTINO, R, POLITO, E, BARTOLI, A, RONDINI, G, CHIRICO, G
Format: Article
Language:English
Subjects:
Anesthesia, Epidural
Anesthesia, General
Anesthesia, Obstetrical
Anesthetics, Inhalation
Anesthetics, Local
Cesarean Section
Delivery, Obstetric
Humans
Infant, Newborn - immunology
Infant, Newborn - metabolism
Killer Cells, Natural - immunology
Lidocaine
Methyl Ethers
mode of delivery
neutrophil function
Neutrophils - immunology
NK activity
Respiratory Burst
sevoflurane
thyroid hormones
Thyroid Hormones - metabolism
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Summary:Background: The aim of this study was to verify if variations of thyroid hormones related to circumstances of delivery and mode of maternal anaesthesia can contribute to neonatal neutrophil respiratory burst and natural killer cell activity. Methods: We evaluated 10 infants born by vaginal delivery (group A), 10 infants born by caesarean section after epidural anaesthesia with lidocaine (group B) and 10 infants born by caesarean section after general anaesthesia with sevoflurane (group C). Results: A significant reduction of neutrophil respiratory burst test was found in groups A and C compared with group B. Natural killer cell (NK) activity with an effector : target ratio of 30 : 1 (NK30) and 10 : 1 (NK10) was significantly higher in group A compared with the B and C groups. In addition, thyroid stimulating hormone (TSH) concentration was significantly reduced in group A compared with the B and C groups. A significant negative correlation was found between TSH and NK30 or NK10. Conclusions: Our results suggest that the mode of delivery and anaesthesia can significantly modify the endocrine‐immune system in the newborn. Caesarean section delivery with regional anaesthesia seems to produce fewer modifications of neonatal immune function compared with general anaesthesia.
ISSN:1155-5645
1460-9592
DOI:10.1046/j.1460-9592.2002.00752.x