Evaluating the Contribution of Synthetic Oxytocin Exposure in the Peripartum Period to Postpartum Depressive Symptoms in African American Women

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PROJECT SUMMARY Background: Synthetic oxytocin is a medication commonly administered perinatally to induce or augment labor and prevent postpartum hemorrhage. However, its long term consequences, especially related to postpartum mood, are largely unknown. This is especially pertinent in African American mothers, a population at higher risk of postpartum depression. African American women have higher rates, in general, of variables that lead to slow labor and therefore are theoretically at greater risk of synthetic oxytocin exposure than Caucasian mothers. Purpose: The purpose of this study is firstly to characterize the indication for and exposure rate of African American women to perinatal synthetic oxytocin. Secondly, we will evaluate the association between exposure to perinatal synthetic oxytocin and depressive symptomatology in African American women at 1 week, 3 months, and 6 months postpartum, after controlling for identified potential confounding variables. Methods: We will enroll a socioeconomically diverse cohort of 160 African American women for this study. As part of two larger, longitudinal studies, participants were recruited between 10-14 weeks gestation and followed through 6 months postpartum. They were visited in their homes at 1 week, 3 months, and 6 months postpartum and assessed for postpartum depression symptomatology using the Edinburgh Postnatal Depression Scale. For the selected subset, we will review their labor and delivery records for detailed data on perinatal synthetic oxytocin exposure. We will combine prenatal, intrapartum, and postpartum variables into a novel dataset to describe synthetic oxytocin exposure and evaluate its relationship to postpartum depression. Implications: The results of this study will provide, for the first time, information on exposure rates to a synthetic hormone that may carry with it increased risk of postpartum depression in this population of African American women, already at high risk of health disparities in birth and infant outcomes. Findings have the potential to impact practice in many ways, including consideration of revising dosing standards and improved risk assessment and surveillance for postpartum depression in exposed women.