The influence of the mode of delivery on circulating cytokine concentrations in the perinatal period Ariadne Malamitsi-Puchner * , Efthimia Protonotariou, Theodora Boutsikou, Evangelos Makrakis, Angeliki Sarandakou, George Creatsas Neonatal Division, 2nd Department of Obstetrics and Gynecology, University of Athens, 19 Soultani Str, GR-10682, Athens, Greece Accepted 7 October 2004 Abstract Background: Cytokines play an important role during labor and full- or preterm delivery. They influence physical immunity of the fetus—neonate and express a leading role in the perinatal period, being present in maternal and fetal tissues. Aim: To investigate whether cytokine concentrations in the mother, fetus and neonate depend on the labor and the mode of the delivery. Study design: Prospective study. Subjects: Seventy-eight healthy, non-smoking parturients (mean age 28F4, range 21—39 years, delivering vaginally: n=52 or by elective cesarean section: n=26) and their single, healthy, appropriate for gestational age, full-term neonates. Outcome measures: We correlated determined circulating levels of IL-2, sIL-2R, IL-4, sIL-4R, IL-6, sIL-6R, IL-1h, IL-8, IFN-g, TNF-a, sTNF RI, sTNF RII and RANTES in the mothers before delivery (MS), the fetuses (UC) and the neonates in days 1 (N1) and 4 (N4) of life, with the mode of delivery. Results: sIL-2R in N1 and N4, sIL-4R in MS, IL-6 in MS and UC, IL-1h in MS, UC and N1, IFN-g in MS and UC, TNF-a in UC, N1 and N4, sTNF RI in UC were significantly higher in cases of vaginal delivery than in cases of elective cesarean section ( p ranging from 0.0005 to 0.05). Conclusions: Vaginal delivery promotes the production of various cytokines and their receptors, which are implicated in neonatal immunity. D 2004 Elsevier Ireland Ltd. All rights reserved. 0378-3782/$ - see front matter D 2004 Elsevier Ireland Ltd. All rights reserved. doi:10.1016/j.earlhumdev.2004.10.017 * Corresponding author. 2nd Department of Obstetrics and Gynecology, University of Athens, Aretaieio Hospital, Athens, Greece. Tel.: +30 6944443815; fax: +30 210 7233330, +30 210 3303110. E-mail address: malamitsi@aias.gr (A. Malamitsi-Puchner). KEYWORDS Cytokines; Soluble receptors; Fetus; Neonate; Vaginal delivery; Elective cesarean section Early Human Development (2005) 81, 387—392 www.elsevier.com/locate/earlhumdev