Oxytocin in pregnancy and the postpartum: relations to labor and its management.
Oxytocin in pregnancy and the postpartum: relations to labor and its management.
复制标题
DOI：
10.3389/fpubh.2014.00001
复制
发表时间：
2014
影响因子：
5.2
通讯作者：
Gold I
中科院分区：
文献类型：
--
作者：
Prevost M;Zelkowitz P;Tulandi T;Hayton B;Feeley N;Carter CS;Joseph L;Pournajafi-Nazarloo H;Yong Ping E;Abenhaim H;Gold I
本研究的目的是检查内源性催产素水平在怀孕和产后状态的变化。我们还探讨了分娩变量和催产素水平之间的关系。这项研究的最终样本包括272名怀孕前三个月的母亲。在妊娠早期和晚期以及产后8周抽取血样。在每个时间点收集社会人口数据，并查阅医疗档案以了解分娩细节。在大多数女性中，循环中的催产素水平在怀孕的前三个月到第三个月期间上升，随后在产后下降。个体之间的催产素水平差异很大，从50 pg/mL到超过2000 pg/mL不等。胎次是妊娠晚期催产素水平的主要预测指标，也是妊娠早期到晚期催产素水平变化的主要预测指标。妊娠晚期的催产素水平预示着自我报告的消极分娩经历，并增加了硬膜外麻醉的机会。产时外源性催产素与产后催产素水平呈正相关。我们的探索性结果表明，妊娠晚期的循环催产素水平可以预测女性将要经历的分娩类型。更重要的是，分娩时使用外源性催产素的量可以预测产后2个月的血浆催产素水平，这表明这种常规干预可能有长期影响，其后果在很大程度上是未知的。
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.