THE EFFECT OF PREOPERATIVE ANXIETY ON FETAL CORD BLOOD TUMOR NECROSIS FACTOR-ALPHA, INTERLEUKIN-6, AND NEONATAL OUTCOMES IN PREGNANT WOMEN

Backgrounds: In this study, we aimed to investigate the relationship in pregnant women who undergo elective cesarean section between the preoperative anxiety (POA) levels and neonatal results and TNF-alpha, IL-6 and IL-8 levels, the pro-inflammatory cytokines in cord blood. Subjects and methods: Sixty-six volunteer patients, aged 18 to 40, who underwent elective cesarean surgery were included in the study. Trait Anxiety Inventory (TAI) was evaluated at the anesthesia outpatient clinic and State Anxiety Inventory (SAI) was determined one hour before cesarean section. Plasma levels of TNF-alpha, IL-6 and IL-8 in the umbilical cord blood were determined using the ELISA method. Fetal cord blood gas, birth weight, and APGAR scores at the 1st and 5th minutes after birth were recorded. Results: The mean preoperative maternal SAI and TAI scores were 46.6 +/- 10.9 and 41.4 +/- 7.8, respectively. There was a significant correlation between POA and fetal birth weight and fetal cord blood TNF-alpha, IL-6 and IL-8 parameters. The inflammatory marker levels in the cord blood of fetuses in the high anxiety groups were significantly higher (p<0.001). Fetal birth weight was significantly lower in the high anxiety groups (p<0.05), whereas there was no significant difference in cord blood gas values. Conclusions: Our results show that an increase in the levels of TNF-alpha, IL-6, and IL-8 cytokines in fetal cord blood in pregnant women with high anxiety levels and this situation causes negative effects on the newborn.