Pitocin linked to adverse affects in newborns — The Bump
December 2013 Moms

Pitocin linked to adverse affects in newborns

Study released today.

May 7, 2013

New Orleans, LA -- Induction and augmentation of labor with the hormone oxytocin may not be as safe for full-term newborns as previously believed, according to research presented today at the Annual Clinical Meeting of The American College of Obstetricians and Gynecologists. Researchers say this is the first study of its kind to present data on the adverse effects of Pitocin use on newborns.

Given intravenously, Pitocin (a brand of oxytocin), is often used to start labor when a pregnant woman is overdue. It is also used to keep a lagging labor going by increasing the frequency, duration, and intensity of uterine contractions.

Primary Investigator Michael S. Tsimis, MD, and fellow researchers at Beth Israel Medical Center in New York City, conducted a retrospective analysis of deliveries that were induced or augmented with oxytocin. The study included more than 3,000 women delivering full-term infants from 2009 to 2011. The researchers used the Adverse Outcome Index, one of several tools used to measure unexpected outcomes in the perinatal setting and to track obstetric illness and death rates.

?As a community of practitioners, we know the adverse effects of Pitocin from the maternal side,? Dr. Tsimis said, ?but much less so from the neonatal side. These results suggest that Pitocin use is associated with adverse effects on neonatal outcomes. It underscores the importance of using valid medical indications when Pitocin is used.?

Researchers found that induction and augmentation of labor with oxytocin was an independent risk factor for unexpected admission to the NICU lasting more than 24 hours for full-term infants. Augmentation also correlated with Apgar scores of fewer than seven at five minutes. The Apgar is a test that evaluates a newborn?s physical condition at one and five minutes after birth based on appearance (skin coloration), pulse (heart rate), grimace response (medically known as ?reflex irritability?), activity and muscle tone, and respiration (breathing rate and effort). A baby who scores eight and above is generally considered to be in good health.

The analysis suggests that oxytocin use may not be as safe as once thought and that proper indications for its use should be documented for further study. ?However, we don?t want to discourage the use of Pitocin, but simply want a more systematic and conscientious approach to the indications for its use,? Dr. Tsimis said.

 They could do a better job of explaining the extent of adverse effects in this release, but that will probably come in later articles.  Honestly, this news isn't too surprising.  It's a strong drug.  What does surprise me is this, "Researchers say this is the first study of its kind to present data on the adverse effects of Pitocin use on newborns. That's comforting.  So one of the most common medications in a delivery room hasn't been thoroughly studied on how it affects the babies it's supposed to be helping.

(No need for anyone to trip over themselves with the "correlation does not imply causation" adage either.)

 

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Re: Pitocin linked to adverse affects in newborns

  • If this was presented today at a congress, there is a complete abstract available that may go into further detail. PI's may also be completing the publication, or the paper is in the process of being published, which sometimes restricts what can be presented/discussed due to embargo. 

    As I mentioned in a previous post, the majority of data on pharmaceuticals in pregnancy is retrospective (and just now really gaining momentum) and animal data. The data in humans is retrospective. 

    Edit: what will (likely) come next is a registry that follows pitocin induced births to determine if there were long term complications. That data would be interesting and is probably the most valuable. Physicians always weigh the risk/benefit profile of a drug/procedure/diagnostic test, and the more data the better.

     Edit 2 for clarity!

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  • I had preeclampsia in both of my previous pregnancies, thus I was induced. I think the risks of staying pregnant at that point I was full term but my BP was through the roof, I had protein in my urine etc outweighed the risks of using pitocin.
    DD #1 3/4/09 DD #2 11/3/11 Surprise! LO #3 due 12/9/13
  • image franklyscarlette:
    .

     That must have been terrifying!

    Off topic, but I love your username! 

    Loss Blog (finally updated)

     image

     imageimage
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    5 cycles of "TTC" - 3 intentional, 2 not so intentional.  5 BFPs.  My rainbow arrived 10/15/14.
    TFMC 08.02.13 at 19+ weeks. Everyday I grieve for my little Olive.

  • image VCGolfNYC:

    image franklyscarlette:
    .

     That must have been terrifying!

    Off topic, but I love your username! 



    Thank you! :

    And yes it was. Not as bad the 2nd time around though.
    DD #1 3/4/09 DD #2 11/3/11 Surprise! LO #3 due 12/9/13
  • mkarnsmkarns
    2500 Comments 250 Answers Third Anniversary 25 Love Its
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    Hmmm correlation is the key word here for me. Infants are at higher risk for ending up in the NICU from the use of the drug, but many of the reasons Pitocin is used is to try to reduce the risk of them ending up there by laboring naturally.

    In my case, my water broke first and there was meconium visible; However even I was not even 1cm dilated. After a few hours of no progression, they hooked me up to Pitocin to speed up the process. If they hadn't forced progression, we would have been at risk for ingestion or infection. So if DS had gone into NICU (he didn't, thankfully)...According to this study it would have been correlated to the use of the Pitocin.

    Unless I have a total comprehension fail. It's likely these days.

     

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  • image VCGolfNYC:

    If this was presented today at a congress, there is a complete abstract available that may go into further detail. PI's may also be completing the publication, or the paper is in the process of being published, which sometimes restricts what can be presented/discussed due to embargo. 

    As I mentioned in a previous post, the majority of data on pharmaceuticals in pregnancy is retrospective (and just now really gaining momentum) and animal data. The data in humans is retrospective. 

    Edit: what will (likely) come next is a registry that follows pitocin induced births to determine if there were long term complications. That data would be interesting and is probably the most valuable. Physicians always weigh the risk/benefit profile of a drug/procedure/diagnostic test, and the more data the better.

     Edit 2 for clarity!

    I was hoping you'd comment. Smile

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  • nlakranlakra
    Second Anniversary 10 Comments Photogenic 5 Love Its
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    I think if they made inductions a last resort and not as much of a common practice, we would not have to worry about this so much... I can say this as someone who went into labor on the 11th day with my second... And ONLY after my membranes were stripped on day 7! I actually had z birth 5 days early with my first.
  • I refused Pitocin when I gave birth to my DD. The doctors tried to tell me I needed it if I wanted an epidural and I told them not to lie to me and that they were not allowed by law to put anything in my body that I refused. I had to sign a waver. haha! Birth went perfect, I made it to 5 1/2 cm before I caved and got the epidural, and not one drop of pitocin went into my system! I will refuse Pitocin at every birth it's unnecessary. There are MANY safe natural alternatives. 
  • tealowltealowl
    5000 Comments 250 Answers 500 Love Its Second Anniversary
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    I'm not a fan of Pitocin, but with any drug, everyone should do their research before accepting any drug.

    I had Pitocin with first DD. Let's see, I was 19, on Medicaid, diagnosed w/preeclampsia.  I was on bed rest a few weeks before I went to an appointment where they checked my BP and sent me over the hospital for more testing.

    They did not tell me I was going in to deliver a month early. When I asked when I was leaving, the nurse laughed at me and then told me what was happening. I was there for 2 days on a drip, with contractions, no pain meds other than some Tylenol. I didn't sleep. I remember them coming in and some other doctor putting some flat wire up me and him rolling his eyes because it hurt SO bad I was jerking and shaking even though I was trying so hard not too. Day 3 they broke my water and in 5 minutes I was in full blown hardcore contractions, I didn't have any time to call my doula and I couldn't handle the pain since it came so quickly. I hadn't slept so I was falling asleep between contractions. No time for an epidural. I was 5 minutes away from a CS they said, and I finally pushed her out.

    No one told me about anything they were doing or what it was or what was going to happen to me. I'm assuming because I was young and poor that I wouldn't care, but I did. But I was too timid to ask.

    So this time I will be very up front with what I want, which is that I want to go drug free and I don't want to automatically be hooked up to an IV and monitor, I want to be free and walk around and I don't want to labor on my back, I want to squat because that's the best way for babies to come out IMO. This may not happen, who knows. But I'm not going to ignorant this time like I was last time.

    "Your truth is different from my truth, and we're both right."

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