The association between maternal body mass index and serial plasma oxytocin levels during labor

PLoS One. 2023 Aug 11;18(8):e0290038. doi: 10.1371/journal.pone.0290038. eCollection 2023.

Abstract

Objective: To evaluate the association between maternal body mass index (BMI) and plasma oxytocin (OT) levels at different OT infusion rates in labor.

Methods: A prospective observational study analyzing serial plasma samples in laboring women with OT infusion. The women were categorized into three groups, women with non-obesity (BMI 18.5-29.9, n = 12), obesity (BMI 30.0-34.9, n = 13), and morbid obesity (BMI ≥ 35.0, n = 15). Plasma OT was analyzed using tandem mass spectrometry.

Results: Except for a low positive correlation between OT levels and BMI and significantly increased plasma OT levels in women with morbid obesity at the OT infusion rate of 3.3 mU/min, no significant differences in OT levels between the BMI groups were found. Further, the inter-individual differences in OT levels were large and no dose-dependent increase of OT levels was seen.

Conclusions: Other factors than plasma OT levels may be more likely to determine the clinical response of OT infusion in women with obesity. Perhaps the observed clinical need and individual response would be a better predictor of plasma OT levels than a pre-determined OT infusion rate. The OT dosage guidelines for labor augmentation should be individualized according to clinical response rather than generalized.

Trial registration: Clinical trial registration: ClinicalTrials.gov ID NCT04093479.

Publication types

  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Body Mass Index
  • Female
  • Humans
  • Labor, Induced / methods
  • Labor, Obstetric*
  • Obesity, Morbid*
  • Oxytocin
  • Pregnancy

Substances

  • Oxytocin

Associated data

  • ClinicalTrials.gov/NCT04093479
  • Dryad/10.5061/dryad.kprr4xh77

Grants and funding

Medical Research Council of Southeast Sweden (FORSS-909171 (SC) FORSS-931749 (MB)), ALF-grants, Region Östergötland (RÖ-966229 (ARI), RÖ-918761 (SC), RÖ-939997 (MB)), The Swedish Research Council (2015-4870(JB)), The Erasmus+ Programme of the European Union (EACH EM JMD, project No 586571). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.