More on "adverse obstetric outcomes" due to low DHEA possibly caused by Caesarean section

New from the Lancet, November 28, 2003:

"Caesarean section and risk of unexplained stillbirth in subsequent pregnancy"


Lancet 2003; 362: 1779-84, Gordon C S Smith, Jill P Pell, and Richard Dobbie  

These findings, also, may be explained by low dehydroepiandrosterone (DHEA).

Smith, et al., suggest the following from the last paragraph of their Lancet
article.   

>From the Discussion: "The association between unexplained stillbirth and
previous caesarean section is biologically plausible. It is possible that
intentional or inadvertent ligation of major uterine vessels at the time of
first caesarean section could affect uterine blood flow in future pregnancies.
Furthermore, previous caesarean delivery is also known to be associated with an
increased risk of abnormal placentation leading to abruption, placenta praevia,
and morbid adherence of the placenta.8-10 Stillbirth is associated with a high
resistance pattern of uterine artery and umbilical artery blood flow, which may
indicate maldevelopment of the villous tree.32-34 The association between
previous caesarean and stillbirth might be, therefore, another manifestation of
abnormal placentation caused by a uterine scar. Consistent with this
interpretation, stillbirths in women with a previous caesarean section were more
likely to be small for gestational age than stillbirths in other women. Previous
caesarean section was also associated with an increased risk of preterm birth
and delivering a liveborn small for gestational age infant. This association
might also be due to uteroplacental dysfunction or to the association between
previous caesarean birth and abruption--since abruption is associated both with
fetal growth restriction and with preterm birth.35 We are not aware of any
studies in which the effects have been assessed of caesarean delivery on uterine
blood flow and mechanisms of placentation in future pregnancies. Such work could
identify the biological basis for our results."

I suggest this report, again, may represent "adverse obstetric outcomes" caused
by low dehydroepiandrosterone (DHEA).  That is, I suggest the Caesarean section
may induce a condition of low DHEA in women that may adversely affect future
pregnancies.  Osorio, et al., reported in 2002 "We found a significant reduction
in the concentrations of DHEA-S and IGF-1 on days 2 and 7 after surgery versus
the preoperative values." (World J Surg. 2002 Sep; 26: 1079-82)
 
For detailed explanation, please see "Prematurity" at the bottom of
www.anthropogeny.com/research.html .  (I do not sell anything nor am I
associated in any way with anyone who does.)