Hippocampal and hypothalamic type I corticosteroid receptor affinities are reduced in adult rats born by a caesarean procedure with or without an added period of anoxia

Examining time-frequency mechanisms of full-fledged deep sleep development in newborns of different gestational age in the first days of their postnatal development

Early age-related changes in EEG time-frequency characteristics during the restful sleep of newborns of different gestational ages result in the development of conventional EEG signs of deep sleep already during the first postnatal week of their life. Allocating newborns to different groups based on their gestational age and duration of postnatal period allowed demonstrating substantial intergroup differences in brain activity during sleep and wakefulness, along with significant variability in the time-frequency characteristics of brain activity. The process of conventional deep sleep development in infants born prior to the week 35 of gestation is associated with an increase in the power of alpha activity in the sensorimotor cortex of the brain.

Animal Models for Assessing Impact of C-Section Delivery on Biological Systems

There has been a significant increase in Caesarean section (C-section) births worldwide over the past two decades and although it is can be a life-saving procedure, the enduring effects on host physiology are now undergoing further scrutiny. Indeed, epidemiological data have linked C-section birth with multiple immune, metabolic and neuropsychiatric diseases. Birth by C-section is known to alter the colonisation of the neonatal gut microbiota (with C-section delivered infants lacking vaginal microbiota associated with passing along the birth canal), which in turn can impact the development and maintenance of many important biological systems. Appropriate animal models are key to disentangling the role of missing microbes in brain health and disease in C-section births. In this review of preclinical studies, we interrogate the effects of C-section birth on the development (and maintenance) of several biological systems and we discuss the involvement of the gut microbiome on C-section-related alterations.

Temporal evolution of quantitative EEG within 3 days of birth in early preterm infants

For the premature newborn, little is known about changes in brain activity during transition to extra-uterine life. We aim to quantify these changes in relation to the longer-term maturation of the developing brain. We analysed EEG for up to 72 hours after birth from 28 infants born <32 weeks of gestation. These infants had favourable neurodevelopment at 2 years of age and were without significant neurological compromise at time of EEG monitoring. Quantitative EEG was generated using features representing EEG power, discontinuity, spectral distribution, and inter-hemispheric connectivity. We found rapid changes in cortical activity over the 3 days distinct from slower changes associated with gestational age: for many features, evolution over 1 day after birth is equivalent to approximately 1 to 2.5 weeks of maturation. Considerable changes in the EEG immediately after birth implies that postnatal adaption significantly influences cerebral activity for early preterm infants. Postnatal age, in addition to gestational age, should be considered when analysing preterm EEG within the first few days after birth.

Factors associated with shorter night-time sleep in toddlers: The Survey of Young Canadians

OBJECTIVES

Adequate sleep in childhood is important for healthy development. No information exists on the predictors of night-time sleep among toddlers in Canada. The aim of this study was to determine the prevalence of and to identify factors associated with sleeping &lt;11 consecutive hours per night among children aged 1-2 years in Canada.

METHODS

Data from the cross sectional Survey of Young Canadians (SYC) 2010 were used. The biological mother reported on toddlers' sleep duration at night. Based on cut-off values used in previous studies, shorter night-time sleep was defined as sleeping &lt;11 hours per night. Multivariable logistic regression was conducted to identify the associations between socio-demographic, maternal, sleep and child-related variables with shorter sleep at night.

RESULTS

Analysis of 3675 toddlers revealed that 57% slept &lt;11 hours per night. Results of the regression analysis showed that being from an immigrantfamily was significantly associated with shorter night-time sleep. Being from a higher income household, having a mother aged between 25 and 34 years at the time of the survey, and napping ≥2 hours during the day were significantly related to sleeping ≥11 hours per night. Other socio-demographic, maternal and child-related variables were not associated with night-time sleep.

CONCLUSION

This was the first population-based, nationally representative study to examine factors related to shorter night-time sleep in Canadian toddlers. Socio-demographic factors and nap duration were associated with night-time sleep duration. More adequate early childhood sleep hygiene awareness efforts are recommended, especially in vulnerable populations.

Mineralocorticoid and glucocorticoid receptors in hippocampus: their impact on neurons survival and behavioral impairment after neonatal brain injury

Glucocorticoids (GC) exert multiple effects within the central nervous system via mineralocorticoid receptors (MR) and glucocorticoid receptors (GR) activation. MR expression is associated with a neuroprotective phenotype, whereas GR activation is implicated in the induction of an endangered neural phenotype and the opposite actions are most evident in hippocampus, where these receptors are predominantly present. Hippocampus has an overall inhibitory influence on the activity of the hypothalamic-pituitary-adrenal (HPA) axis and it has been suggested that efficient learning and adequate stress response depend on the appropriate functioning of the axis brought by coordinated activation of MR and GR in this region. There is a growing body of evidence that perinatal asphyxia causes irreversible damage to the brain leading to neurons loss in regions vulnerable to oxygen shortage especially in hippocampus. In the present review, some aspects of recently acquired insight in the role of GC receptors in promoting neuronal death and survival after hippocampal injury are discussed. Since the unbalance of MR and GR in hippocampus creates a condition of disturbed neuroendocrine regulation their potential impact on behavioral impairment will also be reviewed.

Augmented hypothalamic corticotrophin-releasing hormone mRNA and corticosterone responses to stress in adult rats exposed to perinatal hypoxia

Stressful events before or just after parturition alter the subsequent phenotypical response to stress in a general process termed programming. Hypoxia during the period before and during parturition, and in the postnatal period, is one of the most common causes of perinatal distress, morbidity, and mortality. We have found that perinatal hypoxia (prenatal day 19 to postnatal day 14) augmented the corticosterone response to stress and increased basal corticotrophin-releasing hormone (CRH) mRNA levels in the parvocellular portion of the paraventricular nucleus (PVN) in 6-month-old rats. There was no effect on the levels of hypothalamic parvocellular PVN vasopressin mRNA, anterior pituitary pro-opiomelanocortin or CRH receptor-1 mRNA, or hippocampus glucocorticoid receptor mRNA. We conclude that hypoxia spanning the period just before and for several weeks after parturition programmes the hypothalamic-pituitary-adrenal axis to hyper-respond to acute stress in adulthood, probably as a result of drive from the parvocellular CRH neurones.

Acute perinatal asphyxia at birth has long-term effects on behavioural arousal and maternal behaviour in lactating rats

This study analysed the long-term consequences of an asphyctic event at birth on maternal behaviour and emotionality in rats. Pregnant Wistar rats were delivered by Caesarean section and the pups, still in the uterus horns, were placed into a water bath at 37 degrees C for periods of 0 (Caesarean delivery, CD) or 20 min (asphyxia, CD+20). Control subjects were born by vaginal delivery (VD). Subsequently, pups were given to surrogate mothers, weaned at 21 days, and mated at adulthood. After giving birth, differences in maternal competence and behavioural arousal were assessed observing: (i) maternal behaviour after reunion with the pups following a 3h separation, on postpartum day (PPD) 4; (ii) behaviour in an elevated plus-maze test, on postpartum day 7; and (iii) performance in a fear conditioning test, in which subjects learned to associate a conditional stimulus with an aversive unconditioned stimulus (postpartum days 7-8). Results indicate that subjects in the CD+20 group showed a deficit in maternal care, taking a longer time to retrieve the whole litter and often failing to retrieve all pups. Both CD and CD+20 groups showed higher behavioural activity in the plus-maze. In addition, when tested in the fear conditioning paradigm, the CD+20 group showed a lower latency to perform freezing behaviour in the auditory cue trial. The changes in behavioural arousal described suggest that the dopaminergic system may be a potential neurochemical target for an early hypoxic insult and indicate maternal behaviour as a useful endpoint to study the effects of early birth insult on brain function.

Early life modulators and predictors of adult synaptic plasticity

Early life experience can induce long-lasting changes in brain and behaviour that are opposite in direction, such as enhancement or impairment in regulation of stress response, structural and functional integrity of the hippocampus, and learning and memory. To explore how multiple early life events jointly determine developmental outcome, we investigated the combined effects of neonatal trauma (anoxia on postnatal day 1, P1) and neonatal novelty exposure (P2-21) on adult social recognition memory (3 months of age) and synaptic plasticity in the CA1 of the rat hippocampus (4.5-8 months of age). While neonatal anoxia selectively reduced post-tetanic potentiation (PTP), neonatal novel exposure selectively increased long-term potentiation (LTP). No interaction between anoxia and novelty exposure was found on either PTP or LTP. These findings suggest that the two contrasting neonatal events have selective and distinct effects on two different forms of synaptic plasticity. At the level of behaviour, the effect of novelty exposure on LTP was associated with increased social memory, and the effect of anoxia on PTP was not accompanied by changes in social memory. Such a finding suggests a bias toward the involvement of LTP over PTP in social memory. Finally, we report a surprising finding that an early behavioural measure of emotional response to a novel environment obtained at 25 days of age can predict adult LTP measured several months later. Therefore, individual differences in emotional responses present during the juvenile stage may contribute to adult individual differences in cellular mechanisms that underlie learning and memory.

C-section birth per se or followed by acute global asphyxia altered emotional behaviour in neonate and adult rats

Birth complications such as perinatal asphyxia are considered risk factors for later neurobehavioural disorders. Behavioural analysis of animal models may help to clarify the contribution of particular patterns of early hypoxia and their combination to psychiatric morbidity. Wistar rats underwent caesarean section (c-section) alone or c-section followed by asphyxia, the latter induced by placing pups still in uterus horns into a water bath at 37 degrees C for 20 min. Vaginally delivered pups were used as controls. Frequency of ultrasound emissions was analysed following isolation at a lower temperature than that of the home nest (23+/-0.5 degrees C) and reunion with their mother (3 min) on postnatal day (PND) 13 (maternal potentiation test). A sex-dependent effect of hypoxia was observed, with higher production of ultrasounds in hypoxic males. Caesarean-delivered pups produced significantly more ultrasounds than those vaginally delivered. At adolescence (PND 35) rats underwent a 25 min social interaction test with a conspecific of the same sex and age. Significant alterations in investigative behaviour (inclusive of: nose, anogenital, body sniffing, and following) were evident in caesarean-delivered rats of both sexes, but not in rats experiencing perinatal asphyxia. At adulthood, auditory, and context conditioned responses, analysed in a fear conditioning test, were not markedly affected either by c-section or c-section plus hypoxia. However, hypoxic rats emitted significantly more 22 kHz ultrasounds than c-section or vaginally delivered rats during the training session. In conclusion, differential effects appear to be brought about by c-section and by hypoxia mainly related to emotional/anxious responses.

Neonatal novelty exposure ameliorates anoxia-induced hyperactivity in the open field

We investigated in an animal model of neonatal anoxia whether effects of oxygen deprivation on emotional reactivity can be reversed by neonatal novelty exposure, a behavioral method, involving daily 3min away from the home cage for the first 3 weeks of life. Male neonates were exposed to either 100% N2 gas (Anoxia) or room air (Control) for 25min on postnatal day 1. Within each of the two treatment conditions, one-half of the neonates were further individually exposed to relatively novel non-home cages for 3min daily during postnatal days 2-21 (Novel: NAnoxia=20; NControl=16), while the other half remained in the home cage (Home: NAnoxia=19; NControl=19). Emotional reactivity to an open field was evaluated on postnatal day 25 during four 20-s trials. Among home rats, temporal patterns of open-field activity across multiple trials and initial-trial activity significantly differed between the Anoxia and Control rats. In contrast, these differences were eliminated among the Novel rats. These results show that neonatal novelty exposure, an early-stimulation method that has recently been shown to enhance spatial and social memory, adaptive control of stress response, and hippocampal synaptic plasticity, can also eliminate neonatal anoxia-induced changes in emotional reactivity. These findings suggest that brief and repeated, but mild, changes in the postnatal environment may serve to counteract some of the aversive effects induced by neonatal trauma associated with oxygen deprivation.

Stress responses at birth: determinants of cord arterial cortisol and links with cortisol response in infancy

OBJECTIVE

To investigate (A) the determinants of infant stress response at delivery and (B) test the hypothesis that stress at birth, as reflected by cord arterial cortisol, influences cortisol response to vaccination at two months.

DESIGN

Prospective observational study.

SETTING

Tertiary referral maternity hospital.

POPULATION

One hundred and seventy-two primiparous women with uncomplicated singleton pregnancies.

METHODS

Women were recruited antenatally. At birth, cord arterial blood and obstetric data were collected. Saliva was collected from infants immediately before and after vaccination at two months. Cortisol was analysed from cord blood and saliva by radio-immunoassay.

MAIN OUTCOME MEASURES

Stress response at birth, as demonstrated by cord arterial cortisol; association with saliva cortisol response to vaccination at two months.

RESULTS

Cord arterial cortisol varied with mode of delivery, combined spinal/epidural use and pH. Salivary cortisol response at two months correlated with cord arterial cortisol (r= 0.24, P < 0.05). Infants with the highest and lowest cord arterial cortisol had markedly different cortisol responses at two months (P= 0.017). These groups had different modes of delivery with caesarean rates of <8% in the high cortisol response group and 83% in the low cortisol response group (P < 0.0001).

CONCLUSION

Babies born vaginally mount greater cortisol responses at birth than those delivered by caesarean section. Stress at delivery may influence the infant HPA axis response for up to two months.

Acute global anoxia during C-section birth affects dopamine-mediated behavioural responses and reactivity to stress

Perinatal asphyxia may induce major neurological deficits shortly after birth as well as neurological/behavioural disorders later in development. We used a rat model of global perinatal asphyxia to model acute intrauterine asphyxia around the time of birth. Caesarean section was performed in rats and their pups, still in uterus horns, were placed into a water bath at 37 degrees C for periods of 0, 10 or 20 min. Pups were then given to surrogate mothers, and examined for long-term behavioural effects of the perinatal asphyctic insult. Behavioural assessment included analysis of novelty seeking behaviour at adolescence, while spatial discrimination abilities, response to both an acute and a chronic stress, and the effects of the full D1 receptor agonist SKF 82958 on open field behaviour were assessed at adulthood. Overall, no marked abnormalities were found in the novelty seeking test, in the ability to discriminate spatial changes in the test environment and in physiological response to stress. However, adult rats subjected to severe perinatal asphyxia (20 min) showed lower activity level and lower stereotyped behaviour after the administration of SKF 82958 in an open field test. These results support the observations from human and animal studies that perinatal insult can produce long-term dysfunction of dopaminergic neurotransmission, and points to the need of more thorough examination of the potential effects of perinatal asphyxia on hypothalamic-pituitary-adrenal (HPA) axis. Altogether, the present findings suggest that the present 20 min perinatal asphyxia model might serve for the study of neurodevelopmental disorders associated with perinatal insults.

Neurodevelopmental liabilities in schizophrenia and affective disorders

There is now considerable evidence that both schizophrenia and affective disorders have their origin at least in part in events that occur during early pre- and post-natal development. In the case of schizophrenia, many observations, for example, increased risk for schizophrenia in the offspring of mothers who had influenza A during their second trimester of pregnancy and evidence for abnormal neuronal migration in the cerebral cortex of post mortem tissue from schizophrenic patients, suggest that a second trimester insult may have occurred and that this insult may have increased the risk for the development of schizophrenia in late adolescence or early adulthood. Animal studies have found that rats that undergo exocitotoxic damage to the ventral hippocampus on postnatal day 7 develop exaggerated sensitivity to dopamine-stimulating drugs or to stressful stimuli that becomes apparent after sexual maturity but not before, providing a neurodevelopmental model of schizophrenia. Similarly, post-weaning social isolation leads to enhanced responses to dopaminergic drugs and to stress that emerges after sexual maturity. These animal models are proving to be valuable tools to study the neurobiological mechanisms mediating the influence of early insults to the nervous system on later behavioural functions. In the case of affective disorders, although the evidence is not as strong, a number of the same observations have been made suggesting that an insult during early ontogeny may lead to the development of affective disorders later in life. For example, retrospective studies of people with affective disorders showed that they were more likely to have attained motor milestones at a later age and to have had poorer academic performance as children. There is a wealth of evidence suggesting hyperfunctioning of the hypothalamic-pituitary-adrenal (HPA) axis in affective disorders. Animal studies have shown that early maternal deprivation can lead to lasting changes in the reactivity of the HPA axis to stressful stimuli, providing another link from early experience to adult psychopathology. Continued studies of the effects of pre- and early post-natal events on the development of the nervous system and the relationships of these events to schizophrenia or affective disorder will provide new insights into the mechanisms underlying these common neuropsychiatric illnesses.

Crossroads of corticotropin releasing hormone, corticosteroids and monoamines. About a biological interface between stress and depression

Mental disorders are frequently preceded by stressful events or situations. Depression is a typical case in point. This raises the question, is depression - or possibly better: are certain forms of depression - caused by stress? Can stress be a true pathogenic factor? Phrased differently: can stress destabilize neuronal systems in the central nervous system to such an extent that depressive symptoms are generated? This question is discussed with the corticotrophin releasing hormone (CRH) and MA systems and hypothalamic-pituitary-adrenal (HPA) axis as major foci. The following issues are explored: the effect of antidepressants on corticosteroid receptor gene expression; the behavioral sequellae of CRH administration; CRH disturbances in depression; the impact of early life adversity on the development of the CRH system and on stress reactivity; the interrelationships of stress hormones and monoaminergic (MA ergic) transmission and finally the therapeutic potential of CRH and cortisol antagonists. The available data suggest that CRH overdrive and cortisol overproduction may play a pathogenic role in the occurrence of certain types of depression, directly and/or indirectly, i.e. by induction or exacerbation of disturbances in MA ergic transmission. Stress should, thus, become a major focus of biological depression research.

Prefrontal cortical regulation of hypothalamic-pituitary-adrenal function in the rat and implications for psychopathology: side matters

In recent years, dysfunction of hypothalamic-pituitary-adrenal (HPA) axis function has been implicated in a wide variety of psychiatric conditions. The importance of this system in responding to and coping with stress is well documented, and the integrity of such systems is of obvious significance to good mental health. The prefrontal cortex (PFC) is also heavily implicated in numerous psychopathological conditions. There is thus a growing interest in the potential role the PFC might play in regulating HPA function, and whether abnormalities of these systems are linked. The present paper reviews a number of recent animal studies which have attempted to elucidate the role of the PFC in regulation of HPA axis function, and how these systems may interact. It is concluded that the PFC is involved both in activating HPA responses to stress and in the negative feedback regulation of this system. Cerebral laterality is an important feature of this regulation, with the right PFC being most directly linked to stress-regulatory systems. On this basis, a number of parallels are drawn to the human literature, where asymmetrical disturbances in PFC activity may help explain associated patterns of HPA dysfunction.

Maternal stress in pregnancy and its effect on the human foetus: an overview of research findings

There is evidence from human studies that anxiety or stress during pregnancy can affect birth outcome, causing babies to be born earlier and possibly smaller for gestational age. There is also some suggestive evidence for longer-term behavioural problems. Animal studies indicate that antenatal stress does have a long-term effect on the behaviour of the offspring, including a hyper-responsive hypothalamo-pituitary -adrenal axis. The human foetus can mount an independent stress response from mid-gestation. Two possible mechanisms have been demonstrated by which maternal stress or anxiety may affect the human foetus, the passage of cortisol across the placenta, and an impairment of blood flow through the maternal uterine arteries.

Perinatal distress leads to lateralized medial prefrontal cortical dopamine hypofunction in adult rats

Obstetric complications involving anoxia or prolonged hypoxia are suspected to increase the risk for such mental disorders as schizophrenia and attention deficit-hyperactivity disorder. In previous studies, we reported evidence of enhanced nucleus accumbens (NAcc) dopamine (DA) function in adult rats subjected to intrauterine anoxia during cesarean (C) section birth. In the present study, we used voltammetry and monoamine-sensitive electrodes to investigate the possibility that this functional hyperactivity of the meso-NAcc system is attributable to a loss of inhibitory control from the medial prefrontal cortex (PFC). We monitored the DA responses to repeated once-daily stress in the right or left PFC of adult male rats born vaginally (VAG) or by C-section, either with (C + 15) or without (C + 0) an additional 15 min of intrauterine anoxia. In C + 15 animals, we observed a pronounced and persistent blunting of stress-induced DA release in the right PFC but not in the left; with repeated testing, a similar pattern of dampened right PFC DA stress responses emerged in C + 0 animals. In addition, C + 15 animals were spontaneously more active than VAG and C + 0 animals and displayed an increase in PFC DA transporter density that was also lateralized to the right hemisphere. There was no evidence, however, that PFC D(1) and D(2) receptor levels differed between birth groups or hemisphere. These findings suggest a mechanism by which perinatal complications involving anoxia might contribute to the etiology of mental disorders that have been linked to disturbances in central DA transmission and lateralized PFC dysfunction.

Genetic factors modulate effects of C-section birth on dopaminergic function in the rat

Genetic predisposition and environmental factors such as perinatal complications are believed to contribute to the etiology of schizophrenia, a disorder involving enhanced CNS dopaminergic activity. This study used a rat model to test whether genetic factors and a minor birth complication, i.e. Caesarean section (C-section) birth, interact in producing longterm effects on dopamine-mediated behavior. For this, we compared the effects of vaginal and C-section birth on amphetamine (AMPT)-induced locomotor activity in strains of rats differing in genetic composition. In Sprague-Dawley rats, C-section birth increased AMPT-induced locomotion compared with vaginal birth. By contrast in Lewis rats, C-section birth reduced AMPT-induced locomotion compared with vaginal birth. In Fischer rats, AMPT-induced locomotion was increased by C-section under maternal anesthesia but decreased by C-section after maternal decapitation, compared with vaginal birth. It is concluded that a minor birth complication like C-section can have differing long-term effects on dopaminergic function in the rat, depending on the genetic composition of the individual.

Effects of vaginal birth versus caesarean section birth with general anesthesia on blood gases and brain energy metabolism in neonatal rats

Using a rat model, several laboratories have demonstrated long-term effects of Caesarean section (C-section) birth or of global hypoxia during C-section birth on a variety of central nervous system (CNS) parameters. These studies used C-section delivery from rapidly decapitated dams, to avoid confounding anesthetic effects, or from dams anesthetized with halothane or ether under unspecified conditions. Systemic oxygenation or cerebral energy metabolites in the pups at birth have not been systematically measured in this model. To develop and characterize a C-section model with relevance to the human situation, the present study measured arterial/venous blood gases and pH and brain ATP and lactate, a widely accepted measure of CNS hypoxia, in pups born either vaginally, by C-section from decapitated dams, or by C-section from dams anesthetized with nitrous oxide (N2O) and increasing concentrations of isoflurane under well-defined conditions. Immediately after birth, pups born vaginally, by C-section with maternal decapitation, or by C-section with 2.5% isoflurane showed no group differences in systemic pO2 or pH or brain ATP levels, but pCO2 was elevated in the C-section/2.5% isoflurane group. Pups born by C-section with 3.0, 3.5, or 4.0% isoflurane, showed progressive reductions in blood pO2 and increases in pCO2 and blood pH was reduced with 3.5% isoflurane. Relative to vaginal birth, brain lactate levels were unchanged in pups born by C-section with any concentration (2.5-4.0%) of isoflurane, but reduced in pups born by C-section from decapitated dams. At 1 h (and 4 h) after birth, in both vaginally born controls and the 2.5% isoflurane group, brain lactate fell while blood pO2 and brain ATP remained stable. In the 3.0, 3.5, or 4.0% isoflurane groups, blood gases and pH and brain lactate also normalized to control values. In conclusion, rat neonates show minimal signs of systemic or CNS hypoxia following C-section birth under 2.5% isoflurane with N2O. However, there is a rather narrow window of isoflurane concentrations which produces effective maternal anesthesia without producing respiratory compromise in the neonate. Thus the results indicate that the level of maternal anesthesia employed is an important factor influencing neonatal systemic and CNS oxygenation during C-section birth.

Hypothalamic-pituitary-adrenal axis activity in the inbred Brown Norway and Fischer 344 rat strains

We have examined the basal and the stress-induced secretion of corticosterone in relation to the expression of adrenal steroid receptors in the pituitary, hypothalamus and hippocampus of the inbred Brown Norway and Fischer 344 rat strains. Our data indicated that plasma transcortin and integrated plasma corticosterone levels were significantly higher in Fischer 344 compared to Brown Norway rats. Fischer 344 hypersecrete corticosterone during the dark phase of the diurnal cycle and during the phase of recovery following a 20 min period of restraint stress compared to Brown Norway rats. This hypersecretion of corticosterone was negatively correlated with the size of the adrenal gland but might be related to the higher density of mineralocorticoid receptors in the hippocampus of Fischer 344 rats.

Long-term reciprocal changes in dopamine levels in prefrontal cortex versus nucleus accumbens in rats born by Caesarean section compared to vaginal birth

Epidemiological evidence indicates a higher incidence of pregnancy and birth complications among individuals who later develop schizophrenia, a disorder linked to alterations in mesolimbic dopamine (DA) function. Two birth complications usually included in these epidemiological studies, and still frequently encountered in the general population, are birth by Caesarean section (C-section) and fetal asphyxia. To test the hypothesis that birth complications can produce long-lasting changes in DA systems, the present study examined the effects of Caesarean birth, with or without an added period of anoxia, on steady state monoamine levels and metabolism in various brain regions in a rat model. Pups born vaginally served as controls. At 2 months of age, in animals born by rapid C-section, steady state levels of DA were decreased by 53% in the prefrontal cortex and increased by 40% in both the nucleus accumbens and striatum, in comparison to the vaginally born group. DA turnover increased in the prefrontal cortex, decreased in the nucleus accumbens, and showed no significant change in the striatum, in the C-section group. Thus, birth by a Caesarean procedure produces long-term reciprocal changes in DA levels and metabolism in the nucleus accumbens and prefrontal cortex. This is consistent with the known inhibitory effect of increased prefrontal cortex DA activity on DA release in the nucleus accumbens. By contrast to birth by rapid C-section alone, young adult animals, that had been born by C-section with 15 min of added anoxia, showed no change in steady state DA levels in the prefrontal cortex, nucleus accumbens, or striatum and a significant decrease in DA turnover only in the nucleus accumbens, in comparison to the vaginally born group. Levels of norepinephrine, serotonin, and its metabolite, 5-hydroxyindole acetic acid, were unchanged in all groups, indicating relatively specific effects on DA systems. Although appearing robust at birth on gross observation, more subtle measurements revealed that rat pups born by C-section show altered respiratory rates and activity levels and increased levels of whole brain lactate, suggestive of low grade brain hypoxia, during the first 24 h of life, in comparison to vaginally born controls. Pups born by C-section with 15 min of added acute anoxia were pale, hypotonic, and inactive at birth and showed reduced respiration and high brain lactate levels. However, these alterations resolved by 1-5 h after birth and, with few exceptions, animals in the anoxic group remained normal with respect to these parameters during the remainder of the first 24 h of life. Immediately after birth, levels of plasma epinephrine, a hormone known to play a role in neonatal adaptation to extrauterine life and protection against hypoxia, were decreased in pups born by C-section but increased in pups born by C-section with 15 min added anoxia, in comparison to levels measured in vaginally born controls. These early developmental alterations could contribute to long-term alterations in dopaminergic parameters observed in rats born by C-section, with or without added anoxia. It is concluded that C-section birth is sufficient perturbation to produce long-lasting effects on DA levels and metabolism in the central nervous system of the rat. These findings highlight the sensitivity of DA pathways to variations in birth procedure and support the notion that birth complications might contribute to the pathophysiology of disorders involving central dopaminergic neurons, such as schizophrenia.

Early developmental profiles of plasma corticosterone are altered by birth condition in the rat: a comparison of vaginal birth, cesarean section, and cesarean section with added anoxia

Circulating glucocorticoids play a role during the immediate postnatal period in adapting the neonate to extrauterine life and are also thought to influence tissue development and function in the later postnatal period. In the present study we have used a rat model to test whether birth by cesarean section (C-section), either alone or with an added period of acute anoxia, affects the development profile of basal corticosterone secretion during the first 5 wk of life. Plasma levels of total corticosterone and of corticosteroid-binding globulin were measured at various times after birth in rats born vaginally, by C-section, or by C-section with 15 min of added anoxia. These measures allowed for calculation of levels of free, biologically active, corticosterone. Under all conditions, total corticosterone appeared to accurately reflect levels of free corticosterone. Plasma corticosterone levels measured immediately (< 5 min) after birth were similar in male rat pups born vaginally, by C-section, or by C-section with added anoxia, whereas female pups born by C-section showed a significant increase in free corticosterone at birth, in comparison with vaginally born females. Both male and female animals born by C-section showed a reduction in plasma corticosterone at 1 h (male: 31% of control, p < 0.01; female: 45% of control, p < 0.05) and at 7 d (male: 61% of control, p < 0.01; female: 55% of control, p < 0.05) after birth, in comparison with vaginally born controls. In animals born by C-section with added anoxia, significant reductions in plasma corticosterone were observed for males at 1 h (58% of control; p < 0.05) and for females at 7 d (62% of control; p < 0.05) after birth. At 14 d of age, corticosterone levels were higher in male rats born by C-section either with (227% of control; p < 0.05) or without (239% of control; p < 0.05) added anoxia, in comparison with vaginally born controls. Thus C-section birth produces an early rise in plasma corticosterone on d 14 away from the low values associated with the adrenal quiescent period in the first 1-2 wk in the rat. By 35 d of age, there were no differences in plasma corticosterone attributable to C-section birth and/or acute birth anoxia, in either male or female rats. It is concluded that, in a rat model, birth by C-section has significant effects on the profile of plasma corticosterone during the early weeks of development, a period though to be critical for effects of corticosteroids on developing tissues. Because the rat at birth is developmentally less mature than is the term human neonate, these findings may have implications for development of the premature human neonate.