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The Role of Oxytocin in Primary Cesarean Birth Among Low‐Risk Women
Author(s) -
Clark Rebecca R. S.,
Warren Nicole,
Shermock Kenneth M.,
Perrin Nancy,
Lake Eileen,
Sharps Phyllis W.
Publication year - 2020
Publication title -
journal of midwifery and women's health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.543
H-Index - 62
eISSN - 1542-2011
pISSN - 1526-9523
DOI - 10.1111/jmwh.13157
Subject(s) - medicine , oxytocin , obstetrics , odds ratio , pregnancy , logistic regression , retrospective cohort study , gestational age , gynecology , genetics , biology
To examine whether there is a threshold of oxytocin exposure at which the risk for primary cesarean increases among women who are nulliparous with a term, singleton, vertex fetus (NTSV) and how oxytocin interacts with other risk factors to contribute to this outcome. Methods This was a secondary analysis of the Consortium on Safe Labor data set that used a retrospective cohort study design. Women who met the criteria for NTSV who were not admitted for a prelabor cesarean and for whom oxytocin data were available, were included in the sample. Robust logistic regression was used to examine the association of oxytocin exposure with primary cesarean birth, while controlling for demographic and clinical risk factors and clustering by provider. Results The sample comprised 17,331 women who were exposed to oxytocin during labor. The women were predominantly white non‐Hispanic (59.2%) with an average (SD) gestational age of 39.4 (1.1) weeks and an 18.5% primary cesarean rate. Exposure to greater than 11,400‐milliunits (mU) of oxytocin resulted in 1.6 times increased odds of primary cesarean birth compared with less than 11,400 mU (95% CI 1.01‐2.6). Discussion Exposure to greater than 11,400 mU of oxytocin in labor was associated with an increased odds of primary cesarean birth in NTSV women.