Oxytocin in Pregnancy and the Postpartum: Relations to Labor and Its Management

Abstract

The purpose of this study was to examine variations in endogenous oxytocin levels in pregnancy and postpartum state. We also explored the associations between delivery variables and oxytocin levels. A final sample of 272 mothers in their first trimester of pregnancy was included for the study. Blood samples were drawn during the first trimester and third trimester of pregnancy and at 8 weeks postpartum. Socio-demographic data were collected at each time point and medical files were consulted for delivery details. In most women, levels of circulating oxytocin increased from the first to third trimester of pregnancy followed by a decrease in the postpartum period. Oxytocin levels varied considerably between individuals, ranging from 50 pg/mL to over 2000 pg/mL. Parity was the main predictor of oxytocin levels in the third trimester of pregnancy and of oxytocin level changes from the first to the third trimester of pregnancy. Oxytocin levels in the third trimester of pregnancy predicted a self-reported negative labor experience and increased the chances of having an epidural. Intrapartum exogenous oxytocin was positively associated with levels of oxytocin during the postpartum period. Our exploratory results suggest that circulating oxytocin levels during the third trimester of pregnancy may predict the type of labor a woman will experience. More importantly, the quantity of intrapartum exogenous oxytocin administered during labor predicted plasma oxytocin levels 2 months postpartum, suggesting a possible long-term effect of this routine intervention, the consequences of which are largely unknown.

Attachment security and recent stressful life events predict oxytocin levels: a pilot study of pregnant women with high levels of cumulative psychosocial adversity

“…Moreover, values below her raw OT value of 61.68 pg/ml have been reported in other studies of OT in pregnant women (e.g. Prévost et al, 2014). Finally, her standardized score was above the cut-off of −3.29 for a univariate outlier (Tabachnick & Fidell, 2006).…”

“…The assay has been validated (Carter et al, 2007;Kramer, Cushing, Carter, Wu, & Ottinger, 2004), and this protocol has been used extensively (Ebstein, Knafo, Mankuta, Chew, & Lai, 2012) with stable individual values (Gouin et al, 2010;Weisman, Zagoory-Sharon, Schneiderman, Gordon, & Feldman, 2013). The OT values in the present sample fall within the range reported in other samples of pregnant women using this protocol (Prévost et al, 2014). Participants completed a set of self-report questionnaires.…”

Is the narrow concept of individual autonomy compatible with or in conflict with Evidence-based Medicine in obstetric practice?

“…The hormone oxytocin plays an important role in facilitating bonding. Discrepancies have been found in the pattern of oxytocin release during elective CS and spontaneous vaginal delivery: vaginal birth stimulates the more rapid release of oxytocin (Bell 2014;Prevost 2014). Moreover, maternal well-being and satisfaction with delivery (DiMatteo et al 1996;Lobel et al 2007;Rowlands et al 2007) are factors that affect both bonding processes and breast-feeding (Prior et al 2012).…”

Prediction of vaginal delivery in pregnant women with a uterine scar

“…Известны изменения уровней таких гормонов, как прогестерон и эстрогены у беременных [18]. Однако су-ществует недостаток информации об изменении уровня эндогенного окситоцина в крови беременной.…”

“…Это связано с тем, что окситоцин имеет небольшой период полураспада (не-сколько минут), находится в плазме крови в низких кон-центрациях по сравнению с другими гормонами. Боль-шинство авторов сообщают об увеличении уровней эндо-генного окситоцина на протяжении беременности и до-стижении максимальной его концентрации к моменту родов [12,18,19,20].…”