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.)