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ACOG- study finds adverse effects of pitocin in newborns

Posted by on May. 7, 2013 at 2:56 PM
  • 18 Replies

Study Finds Adverse Effects of Pitocin in Newborns

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.

*Tuesday Poster #74: Oxytocin Usage for Labor Induction or Augmentation and Adverse Neonatal Outcomes


The American College of Obstetricians and Gynecologists (The College), a 501(c)(3) organization, is the nation’s leading group of physicians providing health care for women. As a private, voluntary, nonprofit membership organization of approximately 57,000 members, The College strongly advocates for quality health care for women, maintains the highest standards of clinical practice and continuing education of its members, promotes patient education, and increases awareness among its members and the public of the changing issues facing women’s health care. The American Congress of Obstetricians and Gynecologists (ACOG), a 501(c)(6) organization, is its companion organization. www.acog.org


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by on May. 7, 2013 at 2:56 PM
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Replies (1-10):
jellyphish
by Platinum Member on May. 7, 2013 at 3:45 PM
The results are very vague.
Nicu admittance and apgars under 7. Why? Anything long term/difficult to treat?
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tabi_cat1023
by Group Mod - Tabitha on May. 7, 2013 at 5:30 PM

WOW I have had all 4 labors near term and augmented with pitocin but my kiddos always had high apgars and no nicu

Mrs.Salz
by on May. 7, 2013 at 5:35 PM

I'm guessing it's primarily from increased heart rate and less oxygen as a result of stronger, longer contractions.

Quoting jellyphish:

The results are very vague.
Nicu admittance and apgars under 7. Why? Anything long term/difficult to treat?


GoodyBrook
by on May. 7, 2013 at 7:41 PM

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.

A step in the right direction. 

Too many interventions are suggested without medical indication...

tabi_cat1023
by Group Mod - Tabitha on May. 7, 2013 at 8:51 PM

People are arguing this crap on my FB post

Terpsichore
by Member on May. 7, 2013 at 9:08 PM

The analysis suggests that oxytocin use may not be as safe as once thought. Seriously? Seriously? Try doing some research before declaring something's safety level. 

GoodyBrook
by on May. 7, 2013 at 9:27 PM
1 mom liked this

 


Quoting Terpsichore:

The analysis suggests that oxytocin use may not be as safe as once thought. Seriously? Seriously? Try doing some research before declaring something's safety level. 

The fact that they used the word "oxytocin" in this sentence upset me.  There's nothin UNSAFE about oxytocin, is there?  Perhaps they meant to use the term "synthetic oxytocin" or "pitocin" instead?

 

charity987
by Member on May. 7, 2013 at 9:43 PM
I have been questioning Pitocin for awhile. It's so hard to know what is personality & natural and what could be a side effect of Pitocin. My 1st 2 were induced while my 3rd was a spontaneous labor. My 1st 2 have sleep issues & are on the hyper side. My 2nd actually screamed for the 1st year of his life if he wasn't touching me at all times (even while asleep). They did not tolerate the Pit well & had massive heart rate decels & we almost ended up with Csections. My 3rd is totally different! He's been an awesome sleeper & totally chill. I've often wondered if Pit played a role in all of this.
GoodyBrook
by on May. 7, 2013 at 10:28 PM

 


Quoting charity987:

I have been questioning Pitocin for awhile. It's so hard to know what is personality & natural and what could be a side effect of Pitocin. My 1st 2 were induced while my 3rd was a spontaneous labor. My 1st 2 have sleep issues & are on the hyper side. My 2nd actually screamed for the 1st year of his life if he wasn't touching me at all times (even while asleep). They did not tolerate the Pit well & had massive heart rate decels & we almost ended up with Csections. My 3rd is totally different! He's been an awesome sleeper & totally chill. I've often wondered if Pit played a role in all of this.


I know of one day-care provider who says she is able to pinpoint kids who didn't have Pitocin at birth and kids who did.  Curious... 

Mine were both induced with Pitocin.  They both sleep great and are pretty independant and laid back.

charity987
by Member on May. 7, 2013 at 10:39 PM
I'm sure that personality plays a huge part in it. It just has always made me wonder if perhaps it's exaggerated by Pitocin.

In regards to this study though, both of mine had awesome APGAR scores & never spent any time in the NICU.


Quoting GoodyBrook:

 




Quoting charity987:

I have been questioning Pitocin for awhile. It's so hard to know what is personality & natural and what could be a side effect of Pitocin. My 1st 2 were induced while my 3rd was a spontaneous labor. My 1st 2 have sleep issues & are on the hyper side. My 2nd actually screamed for the 1st year of his life if he wasn't touching me at all times (even while asleep). They did not tolerate the Pit well & had massive heart rate decels & we almost ended up with Csections. My 3rd is totally different! He's been an awesome sleeper & totally chill. I've often wondered if Pit played a role in all of this.



I know of one day-care provider who says she is able to pinpoint kids who didn't have Pitocin at birth and kids who did.  Curious... 


Mine were both induced with Pitocin.  They both sleep great and are pretty independant and laid back.

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