possible connections between C-sections and medical conditions?

MsFortune

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MsFortune
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http://scienceline.org/2012/06/the-epigenetic-jury-is-still-out-on-c-sections/

anyone with opinions about epigenics and how likely this is? Interested in views.

Many people know the genome is not immune to environmental forces. A nuclear bomb can mutate DNA. A retrovirus like HIV can incorporate itself into genetic code. But what about subtler events? Scientists are beginning to learn how certain twists and trials, such as famine or stress, might influence which genes in our DNA are switched on or off.

Having a C-section, a group of nurses and midwives are now suggesting, could possibly be one of those twists. They are both eagerly and carefully launching studies to examine possible connections between C-sections and medical conditions. The idea is controversial, unproven and has many skeptics, but birth experts say that studying C-sections’ effects on infants and their descendents is an important question that requires experimental testing.
 
I would think it possible that a c-section is actually less stressful to Mom than long labor. Therefore, if triggering any epigenetics, it would trigger the lack. Hmm, default? How would we know?

Or maybe the anesthetic would trigger something? But epidurals don't cross the placental barrier, eh?
 
I think if we were that fragile we would all have three heads by now with all of the environmental insults resulting from an industrialized civilization.

The anesthesia in an epidural does cross the placental barrier to some degree making the baby sleepy at delivery and not enthusiastic about nursing for the first 24 hours. However, the poor kid's head is getting molded as it passes through the birth canal so I figure the anesthesia might help with the pain that might be associated with that. You know it can't possibly feel good to the infant being born vaginally.
 
This panel is as reputable as a lunchroom meeting of some nurses at a hospital. If they were discussing the mechanics of delivery and such, then the opinions of midwives and delivery nurses might be worth something, but their conjecture about epigenetics of the process are quite a stretch. I'm not saying that they're wrong because they're nurses, just that there's no reason to lend their idea credence based on their expertise. There's also a quotation from one of the panel members that makes it clear that her goal, at least, is to increase the frequency of vaginal deliveries, not to try to figure out which of the two methods is better for an infant or its mother.

The only actual study given in the paper says that there was a difference in DNA methylation for 3-5 days between the two delivery methods. It says nothing about whether there is a long term effect or whether that effect, if it does exist, is beneficial or detrimental.
 
Jodie said:
I think if we were that fragile we would all have three heads by now with all of the environmental insults resulting from an industrialized civilization.

The anesthesia in an epidural does cross the placental barrier to some degree making the baby sleepy at delivery and not enthusiastic about nursing for the first 24 hours.

You know it can't possibly feel good to the infant being born vaginally.
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No, epidurals do not effect the baby. They are local to the mother's spinal column and don't enter her bloodstream so anesthesia does not get anywhere near the placenta.

But yeah, vaginal birth sounds pretty awful from the baby's POV.

I found this study interesting since it is being done by people with a foregone conclusion - they want c sections to be bad - so they are looking to prove it - without any real scientific theory of why this would be so. They just are ideaologically opposed to c sections.
 
MsFortune said:
No, epidurals do not effect the baby. They are local to the mother's spinal column and don't enter her bloodstream so anesthesia does not get anywhere near the placenta.

But yeah, vaginal birth sounds pretty awful from the baby's POV.

I found this study interesting since it is being done by people with a foregone conclusion - they want c sections to be bad - so they are looking to prove it - without any real scientific theory of why this would be so. They just are ideaologically opposed to c sections.
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Sorry, I'm a nurse-midwife and worked in L&D for 23 years, the medication in an epidural does seem to affect the baby to a small degree but nothing that is long term in my experience. More research needs to be done to see if perhaps a component of the anesthesia or dosage of the anesthesia is the problem. A longitudinal study with larger sample sizes might be more helpful since a lot of factors determine the success of breastfeeding. Check out the bottom of page 792 in this link that describes what drugs are present in fetal blood at delivery:

http://books.google.com/books?id=vJ8A0Xgl8gUC&pg=PA785&lpg=PA785&dq=epidural+anesthesia+and+placental+barrier&source=bl&ots=_KaZVy6C5Q&sig=zYC21bkOBoP9XozVD3-r9iJXAfI&hl=en&sa=X&ei=8oHaT4alDojO9QTngenxAw&ved=0CFEQ6AEwAQ#v=onepage&q=epidural%20anesthesia%20and%20placental%20barrier&f=false

http://www.ncbi.nlm.nih.gov/pubmed/12583645

http://www.internationalbreastfeedingjournal.com/content/1/1/24

Some providers are militant about natural child birth and will use any excuse to talk the patient out of the epidural but most of us were ambivalent. It truly is a personal decision for the patient. There are pros and cons to doing it either way and other factors not related to anesthesia that can result in c-section.
 
Jodie said:
Sorry, I'm a nurse-midwife and worked in L&D for 23 years, the medication in an epidural does seem to affect the baby to a small degree but nothing that is long term in my experience. More research needs to be done to see if perhaps a component of the anesthesia or dosage of the anesthesia is the problem. A longitudinal study with larger sample sizes might be more helpful since a lot of factors determine the success of breastfeeding. Check out the bottom of page 792 in this link that describes what drugs are present in fetal blood at delivery:

http://books.google.com/books?id=vJ8A0Xgl8gUC&pg=PA785&lpg=PA785&dq=epidural+anesthesia+and+placental+barrier&source=bl&ots=_KaZVy6C5Q&sig=zYC21bkOBoP9XozVD3-r9iJXAfI&hl=en&sa=X&ei=8oHaT4alDojO9QTngenxAw&ved=0CFEQ6AEwAQ#v=onepage&q=epidural%20anesthesia%20and%20placental%20barrier&f=false

http://www.ncbi.nlm.nih.gov/pubmed/12583645

http://www.internationalbreastfeedingjournal.com/content/1/1/24

Some providers are militant about natural child birth and will use any excuse to talk the patient out of the epidural but most of us were ambivalent. It truly is a personal decision for the patient. There are pros and cons to doing it either way and other factors not related to anesthesia that can result in c-section.
Click to expand...

A very very small amount of the anesthesia ends up in the mother's bloodstream. But it's a very small amount - if were significant, the woman would be anesthesized. Of that very small amount in the mother's blood, an even much smaller amount may very slowly get through the placenta. But we are talking an infentesimal amount.
 
MsFortune said:
A very very small amount of the anesthesia ends up in the mother's bloodstream. But it's a very small amount - if were significant, the woman would be anesthesized. Of that very small amount in the mother's blood, an even much smaller amount may very slowly get through the placenta. But we are talking an infentesimal amount.
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Not necessarily, it depends on the cocktail mix, the initial bolus dosage, and duration of the epidural anesthesia. It is a small amount present in the neonate at delivery, but it is enough to affect behaviors according to what research has been done.
 
Isn't there some connection between being born via a c section and getting stabbed to death in the middle of March
at least it seemed supported by the early data
:p
 
Marduk said:
Isn't there some connection between being born via a c section and getting stabbed to death in the middle of March
at least it seemed supported by the early data
:p
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LOLOL...beware the Ides, never schedule a c-section on March 15th.
 
Marduk said:
Isn't there some connection between being born via a c section and getting stabbed to death in the middle of March
at least it seemed supported by the early data
:p
Click to expand...

Yes, and Scottish kings who have achieved their rank via assassination should watch out for those who were "from their mothers' wombs untimely ripp'd." :D
 
MsFortune said:
http://scienceline.org/2012/06/the-epigenetic-jury-is-still-out-on-c-sections/

anyone with opinions about epigenics and how likely this is? Interested in views.

Many people know the genome is not immune to environmental forces. A nuclear bomb can mutate DNA. A retrovirus like HIV can incorporate itself into genetic code. But what about subtler events? Scientists are beginning to learn how certain twists and trials, such as famine or stress, might influence which genes in our DNA are switched on or off.

Having a C-section, a group of nurses and midwives are now suggesting, could possibly be one of those twists. They are both eagerly and carefully launching studies to examine possible connections between C-sections and medical conditions. The idea is controversial, unproven and has many skeptics, but birth experts say that studying C-sections’ effects on infants and their descendents is an important question that requires experimental testing.
Click to expand...

Epigenetics scared the crap out of me about 10 years ago when someone announced that apparently fat parents enabled fat-storing extras and that these could get passed on to kids. It was much harder to shut them back off then turn them on.
 
This quote from the OP link suggests one of those ideologue agendas:
Hannah Dahlen, an Australian midwife, says it could increase respect and demand for vaginal birth. “We’re at the beginning of a very exciting time,” Dahlen says. “I think in 10 years we will potentially look back at what we are doing now and think, ‘What on earth did we do?’
Click to expand...
Not a very scientific basis for an hypothesis.
 
The associations I've heard of have more to do with the physical effects of vaginal birth on the child than with epigenetics. Specifically two things: 1) The neonate gets the mother's vaginal flora in its mouth and this could be the basis of the initial gastrointestinal flora, and 2) The squeezing action of going through that narrow muscular tube seems to have a beneficial effect on the lungs (gets the amniotic fluid out) and may affect the brain since the head can get squished into a nice pointy shape.
 
That would be true Teresa, I actually can't think of any long term medical conditions for the neonate associated with trauma from a C-section. Forceps and vacuum extraction deliveries can result in unintended damage if done while the baby is too high in the birth canal. Shoulder Dystocia is also always a risk with a LGA baby in vaginal delivery.

However, elective c-sections are abused. They finally came out with a position statement on standards of care that state the mother has to be term. We had sections being done at 37 weeks. Due dates are never exact so you would end up risking getting a premature 36 weeker sometimes. I can see long term medical conditions possibly arising from this type of scenario.
 
Am I missing something here? The idea of epigenetics is that certain actions have an actual effect on genes. Now I suppose that certain traumas might cause genetic damage, but is that not testable? Have any epigenetic proponents come up with convincing evidence for predictable genetic changes?

p.s. I disagree with some of the criteria here. Tool shops in the best cities are frequented by women as well as men. When my daughter asked for a good torque wrench for Christmas a couple of years ago, I figured the world was finally evolving a bit.
 
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You would never be able to prove that what developed 30 years later, or even in the next generation or two, was related to what happened to you during childbirth.

When they were talking about trauma like that, I was thinking of poisons/chemicals , and jumped to the anesthesia. I don't think the trauma of the birth itself is going to cause enough stress to create a long term genetic change.
 
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