Stress Response Assessment between First and Second Elective Caesarean Sections by Comparing Cortisol Levels

Dionysios Galatis, Christos Benekos, os, Panagiotis-Konstantinos Karachalios, Antonios Strongylos, Foteini Anifantaki, Ioannis Dalivigkas, Argyrios Monastiriotis, Nikolaos Kiriakopoulos


Objectives. The aim of this study was to compare the stress response produced during elective CS for the first and second time. For that goal, cortisol blood levels before, during and after childbirth were measured.

Materials and Methods. We performed this prospective observational study during the period of September 2020 to September 2021. Blood samples were taken from all participants at three different stages. A statistical analysis was performed to compare the CS1 (first elective Caesarean) and CS2 (second elective Caesarean) groups.

Results. At every stage, the levels of cortisol were statistically higher in the CS1 group than in the CS2 group. Therefore, CS2 generates a significantly less stressful response than CS1. Between stages, in CS2 cortisol was lowered at a faster rate than in CS1, meaning the stress response initiated was present for a longer time period in the CS1 group.

Conclusion. A second elective caesarean section is a safe procedure that does not place an unnecessary burden upon the mother. This is an important fact that practitioners can rely upon while designing the ideal management of a pregnant woman for the stressful environment of birth.


Cortisol; Stress Response; Caesarean Section; Pregnancy; Childbirth

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