Evidence map›Paper›PMID 36781431›Full record

ArticleArchives of gynecology and obstetrics2024

Association between duration of intrapartum oxytocin exposure and obstetric hemorrhage.

Megan V Alexander, Michelle J Wang, Akanksha Srivastava, Swetha Tummala, Diana Abbas, Sara Young, Lindsey Claus, Christina Yarrington, Ashley Comfort

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Article in Archives of gynecology and obstetrics, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0cells of the map it votes in
0citing papers in PubMed
2.9field-weighted citation impact, top 10% of its field
1 · What the graph read from it

What it found

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2 · The registry

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3 · Its place in the literature

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0 citing papers in PubMed, 5 citations in OpenAlex.

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4 · The record

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5 · Who and what money

Authors and funding

9 authors at 2 institutions in 1 country.

Megan V AlexanderBoston University School of Medicine, Boston, MA, USA. meganva@bu.edu.ORCID 0000-0003-1266-3904
Michelle J WangDepartment of Obstetrics and Gynecology, Boston Medical Center, 770 Albany Street, Dowling 4, Boston, MA, 02118, USA.
Akanksha SrivastavaBoston University School of Medicine, Boston, MA, USA.
Swetha TummalaBoston University School of Medicine, Boston, MA, USA.
Diana AbbasBoston University School of Medicine, Boston, MA, USA.
Sara YoungBoston University School of Medicine, Boston, MA, USA.
Lindsey ClausBoston University School of Medicine, Boston, MA, USA.
Christina YarringtonBoston University School of Medicine, Boston, MA, USA.
Ashley ComfortBoston University School of Medicine, Boston, MA, USA.
Boston Medical Center · USBoston University · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeProlonged duration of intrapartum oxytocin exposure is included as a risk factor within widely adopted obstetric hemorrhage risk stratification tools. However, the duration of exposure that confers increased risk is poorly understood. This study aimed to assess the association between duration of intrapartum oxytocin exposure and obstetric blood loss, as measured by quantitative blood loss, and hemorrhage-related maternal morbidity.

methodsThis was a retrospective cohort study of all deliveries from 2018 to 2019 at a single medical center. We included patients who had received any intrapartum oxytocin, and we categorized them into 1 of 5 groups: > 0-2, ≥ 2-4, ≥ 4-6, ≥ 6-12, and ≥ 12 h of intrapartum oxytocin exposure. The primary outcomes were mean quantitative blood loss, proportion with obstetric hemorrhage (defined as quantitative blood loss ≥ 1000 mL), and proportion with obstetric hemorrhage-related morbidity, a composite of hemorrhage-related morbidity outcomes. Secondary outcomes were hemorrhage-related pharmacologic and procedural interventions. A stratified analysis was also conducted to examine primary and secondary outcomes by delivery mode.

resultsOf 5332 deliveries between January 1, 2018 and December 31, 2019 at our institution, 2232 (41.9%) utilized oxytocin for induction or augmentation. 326 (14.6%) had exposure of > 0-2 h, 295 (13.2%) ≥ 2-4 h, 298 (13.4%) ≥ 4-6 h, 562 (25.2%) ≥ 6-12 h, and 751 (33.6%) ≥ 12 h. Across all deliveries, there was higher mean quantitative blood loss (p < 0.01) as well as increased odds of obstetric hemorrhage (adjusted odds ratio [aOR] 1.52, 95% confidence interval [CI] 1.21-1.91) for those with ≥ 12 h of oxytocin compared to all groups between > 0-12 h of exposure. In our stratified analysis, ≥ 12 h of oxytocin exposure was associated with higher mean quantitative blood loss (p = 0.04) and odds of obstetric hemorrhage in vaginal deliveries (aOR 1.47, 95% CI: 1.03-2.11), though not in cesarean deliveries (aOR 1.16, 95% CI 0.82-1.62). There were no differences in proportion with obstetric hemorrhage-related morbidity across all deliveries (p = 0.40) or in the stratified analysis.

conclusionIntrapartum oxytocin exposure of ≥ 12 h was associated with increased quantitative blood loss and odds of obstetric hemorrhage in vaginal, but not cesarean, deliveries.

Indexed as

OxytocinPostpartum HemorrhageDelivery, ObstetricFemaleHumansParturitionPregnancyRetrospective StudiesOxytocinLabor augmentationLabor inductionMaternal morbidityObstetric hemorrhageOxytocinPostpartum hemorrhageQuantitative blood loss

Identifiers

PMID36781431
OpenAlexW4320490175

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.