Epidural Analgesia With or Without Oxytocin, but Not Oxytocin Alone, Administered During Birth Disturbs Infant Pre-feeding and Sucking Behaviors and Maternal Oxytocin Levels in Connection With a Breastfeed Two Days Later

Takahashi, Yuki; Uvnäs‐Moberg, Kerstin; Nissen, Eva; Lidfors, Lena; Ransjö‐Arvidson, Anna‐Berit; Jonas, Wibke

doi:10.3389/fnins.2021.673184

Cited by 8 publications

(11 citation statements)

References 38 publications

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“…Nine studies (reported in twelve publications) reported maternal plasma oxytocin levels in response to postpartum synthetic oxytocin administration [ 47 , 49 , 52 , 54 , 55 , 57 , 68 – 70 , 72 – 74 ].…”

Section: Resultsmentioning

confidence: 99%

“…One study, reported in three publications (Handlin (2009) and Jonas (2009) and more recently reanalysed by Takahashi and colleagues, (2021)) described plasma oxytocin levels during breastfeeding 2 days postpartum in relation to postpartum intramuscular injection of synthetic oxytocin and also in relation to intravenous infusion during labour [ 54 , 57 , 68 ]. This study, and the three publications, are discussed in detail below: ‘Administration of synthetic oxytocin with later postpartum sampling: exposed vs. unexposed analysis.’…”

Section: Resultsmentioning

confidence: 99%

“…Jonas and colleagues (2009), also reported by Handlin and colleagues (2009), sampled oxytocin levels frequently during a breastfeeding episode two days after birth in primiparous women grouped according to medical interventions in labour and birth, including synthetic oxytocin administered by intravenous infusion during labour and by intramuscular injection (10 IU) postpartum [ 54 , 57 ]. A subset of this data was reanalysed by Takahashi (2021) [ 68 ].…”

Section: Resultsmentioning

confidence: 99%

“…Jonas/Handlin report median total doses of intrapartum and intramuscular postpartum synthetic oxytocin as 0.9 IU and 10 IU respectively, and the Takahashi subset reported 1.1 IU intrapartum and 10 IU postpartum total doses [ 54 , 57 , 68 ]. Analysis was performed using ELISA, and data allowed analysis of dose-exposure relationships, as well as interactions between synthetic oxytocin and other interventions.…”

Section: Resultsmentioning

confidence: 99%

“…Epidural Analgesia With or Without Oxytocin, but Not Oxytocin Alone, Administered During Birth Disturbs Infant Pre-feeding and Sucking Behaviors and Maternal Oxytocin Levels in Connection With a Breastfeed Two Days Later. Front Neurosci 2021;15:673184 [ 68 ] (5 W) (8 W) (10 W) (13 W) This study is a reanalysis of published in Handlin (2009) and Jonas (2009) Other data from this study regarding blood pressure, cortisol levels and personality changes in relation to interventions is published in separate articles [updated search 2022 Rev1] Thornton S.; Davison JM. ; Baylis PH.…”

Section: Methodsmentioning

confidence: 99%

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Maternal and newborn plasma oxytocin levels in response to maternal synthetic oxytocin administration during labour, birth and postpartum – a systematic review with implications for the function of the oxytocinergic system

Buckley

Uvnäs‐Moberg

Pajalić

et al. 2023

BMC Pregnancy Childbirth

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Background The reproductive hormone oxytocin facilitates labour, birth and postpartum adaptations for women and newborns. Synthetic oxytocin is commonly given to induce or augment labour and to decrease postpartum bleeding. Aim To systematically review studies measuring plasma oxytocin levels in women and newborns following maternal administration of synthetic oxytocin during labour, birth and/or postpartum and to consider possible impacts on endogenous oxytocin and related systems. Methods Systematic searches of PubMed, CINAHL, PsycInfo and Scopus databases followed PRISMA guidelines, including all peer-reviewed studies in languages understood by the authors. Thirty-five publications met inclusion criteria, including 1373 women and 148 newborns. Studies varied substantially in design and methodology, so classical meta-analysis was not possible. Therefore, results were categorized, analysed and summarised in text and tables. Results Infusions of synthetic oxytocin increased maternal plasma oxytocin levels dose-dependently; doubling the infusion rate approximately doubled oxytocin levels. Infusions below 10 milliunits per minute (mU/min) did not raise maternal oxytocin above the range observed in physiological labour. At high intrapartum infusion rates (up to 32 mU/min) maternal plasma oxytocin reached 2–3 times physiological levels. Postpartum synthetic oxytocin regimens used comparatively higher doses with shorter duration compared to labour, giving greater but transient maternal oxytocin elevations. Total postpartum dose was comparable to total intrapartum dose following vaginal birth, but post-caesarean dosages were higher. Newborn oxytocin levels were higher in the umbilical artery vs. umbilical vein, and both were higher than maternal plasma levels, implying substantial fetal oxytocin production in labour. Newborn oxytocin levels were not further elevated following maternal intrapartum synthetic oxytocin, suggesting that synthetic oxytocin at clinical doses does not cross from mother to fetus. Conclusions Synthetic oxytocin infusion during labour increased maternal plasma oxytocin levels 2–3-fold at the highest doses and was not associated with neonatal plasma oxytocin elevations. Therefore, direct effects from synthetic oxytocin transfer to maternal brain or fetus are unlikely. However, infusions of synthetic oxytocin in labour change uterine contraction patterns. This may influence uterine blood flow and maternal autonomic nervous system activity, potentially harming the fetus and increasing maternal pain and stress.

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