Association of peripartum synthetic oxytocin administration and depressive and anxiety disorders within the first postpartum year

Abstract

Background Due to its potent effects on social behavior, including maternal behavior, oxytocin has been identified as a potential mediator of postpartum depression and anxiety. The objective of this study was to examine the relationship between peripartum synthetic oxytocin administration and the development of depressive and anxiety disorders within the first year postpartum. We hypothesized that women exposed to peripartum synthetic oxytocin would have a reduced risk of postpartum depressive and anxiety disorders compared with those without any exposure. Methods Population-based data available through the Massachusetts Integrated Clinical Academic Research Database (MiCARD) was used to retrospectively (2005–2014) examine this relationship and calculate the relative risk of peripartum synthetic oxytocin for the development of postpartum depressive and anxiety disorders in exposed (n=9,684) compared to unexposed (n=37,048) deliveries. Results Among deliveries to women with a history of prepregnancy depressive or anxiety disorder, exposure to peripartum oxytocin increased the risk of postpartum depressive or anxiety disorder by 36% (RR: 1.36; 95%CI: 1.20–1.55). In deliveries to women with no history of prepregnancy depressive or anxiety disorder, exposure to peripartum oxytocin increased the risk of postpartum depressive or anxiety disorder by 32% compared to those not exposed (RR: 1.32; 95% CI: 1.23–1.42). Conclusions Contrary to our hypothesis, results indicate that women with peripartum exposure to synthetic oxytocin had a higher relative risk of receiving a documented depressive or anxiety disorder diagnosis or antidepressant/anxiolytic prescription within the first year postpartum than women without synthetic oxytocin exposure.

Testing the waters — A cross-sectional survey of views about waterbirth among Swedish health professionals

“…There are many reasons to limit the use of oxytocin intrapartum; a decreased endogenous oxytocin response during breastfeeding for women having EDA (118), an increased risk for postpartum depressions (146) as well as negative birth experience (23) have been observed.…”

Oxytocin administration for induction and augmentation of labour in Polish maternity units– an observational study

“…Endogenous Oxytocin promotes good mood and regulates maternal behaviour. The use of synthetic oxytocin impairs the natural secretion of endogenous oxytocin which may result in a shorter breastfeeding duration [19] and a higher risk of symptoms of anxiety and depression in women [20].…”

The oxytocinergic system in PTSD following traumatic childbirth: endogenous and exogenous oxytocin in the peripartum period

“…Despite some positive associations of intrapartum synthetic OT with higher plasma OT levels postpartum (Gu et al 2016), lower aggression (Prevost et al 2014), and higher socialization during breastfeeding (Jonas et al 2009), other studies point to adverse outcomes associated with high doses of intrapartum synthetic OT such as less successful breastfeeding (Olza Fernández et al 2012;Gu et al 2016) and negative emotional wellbeing of the mother postpartum (i.e., depression and anxiety but not PTSD-symptoms) (Gu et al 2016). Findings from a large retrospective population-based study also suggest that women exposed to intrapartum synthetic OT have a greater risk of developing depressive and/or anxiety disorders within the first year postpartum as compared with women not exposed to intrapartum synthetic OT, irrespective of pre-pregnancy depression or anxiety or mode of delivery (Kroll-Desrosiers et al 2017). These potential adverse effects of synthetic intrapartum OT could be explained by desensitization of the OTR due to excessive amounts of synthetic OT.…”