Journal of Japan Academy of Midwifery
Online ISSN : 1882-4307
Print ISSN : 0917-6357
ISSN-L : 0917-6357
Original articles
A longitudinal study of changes in salivary sIgA during pregnancy and the puerperal period, focusing on differences between vaginal birth and cesarean section
Chie SHITAMIMasao TAMARUKazuko TAKENAKAYoshito TANAKA
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JOURNAL FREE ACCESS

2008 Volume 22 Issue 2 Pages 170-179

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Abstract

Objective
It is known that the concentration of salivary secretory IgA (sIgA), which is a local immunity, changes according to different levels of stress. In previous research, it has been reported that there are changes in the concentration of salivary sIgA due to exercise load and psychological stress, but there is not much data about pregnant and puerperal women. The objective of this research is to collect longitudinal and basic data about the salivary sIgA concentration from the time of pregnancy to the puerperal period, and to compare stress levels of Cesarean section delivery with those of vaginal delivery.
Method
The salivary sIgA concentration was measured using the enzyme immunoassay (EIA) against 61 healthy pregnant women (of whom 19 had decided on scheduled Caesarean deliveries, and 42 on vaginal deliveries. Saliva samples were taken three times: during pregnancy, directly after delivery, and during the puerperal period. The subjects were also asked to complete a "Profile of Moods States" (POMS). The ages of the subjects, parous experience, duration of labor, blood loss, and gestational age were also noted, as physical factors.
Results
1) There was a large individual difference in the salivary sIgA, between subjects but a rather strong positive correlation (P<.01) was seen in the longitudinal changes in the sIgA concentration (during pregnancy, directly after delivery, and in the puerperal period). 2) In the vaginal delivery group, there was no change in the sIgA concentration between the pregnancy period and directly after the delivery, but there was an increase in the puerperal period (P<.01). 3) However, the salivary sIgA, directly after delivery were significant higher than that in during pregnancy and puerperal period in subjects who received Cesarean section (P<.0001). 4) There were no significant differences in the sIgA concentration due to physical factors such as parous experience, duration of labor, blood-loss during delivery, age and gestational age. 5) The POMS scores changed during pregnancy, directly after delivery and in the puerperal period, but did not have any relationship with the sIgA concentration.
Conclusions
Depending on the method of delivery, it can be understood that the changes in the sIgA concentration during pregnancy and the puerperal period have different dynamics. These findings suggest that directly after delivery Cesarean section group mothers were under a lot of stress by comparison with the vaginal birth group. However, in view of the marked increase in the sIgA concentration in the Cesarean section group, it is also possible that other variables apart from stress (such as the influence of anesthetics) may affect the sIgA values. There is a need to consider particular factors linked to method of delivery when evaluating levels of stress during pregnancy and the puerperal period.

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© 2008 Japan Academy of Midwifery
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