Side-effects of oxytocin in postpartum hemorrhage: a systematic review and meta-analysis

Yanfei Zeng; Yinghui Zhang; Manhua Zhen; Li Lao; Yubo Ma; Li Liu; Dazhi Fan; Wen Ai

Side-effects of oxytocin in postpartum hemorrhage: a systematic review and meta-analysis

Am J Transl Res. 2022 Mar 15;14(3):1934-1951. eCollection 2022.

Authors

Yanfei Zeng¹, Yinghui Zhang¹, Manhua Zhen¹, Li Lao¹, Yubo Ma², Li Liu³, Dazhi Fan⁴, Wen Ai¹

Affiliations

¹ Department of Obstetrics and Gynecology, Foshan Fosun Chancheng Hospital Foshan 528031, Guangdong, China.
² Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University Hefei 230032, Anhui, China.
³ Department of Library, The First Affiliated Hospital, College of Medicine, Zhejiang University Hangzhou 310003, Zhejiang, China.
⁴ Foshan Fetal Medicine Research Institute, Affiliated Foshan Women and Children Hospital, Southern Medical University Foshan 528000, Guangdong, China.

PMID: 35422945
PMCID: PMC8991119

Abstract

Objective: To evaluate the side-effects of oxytocin for the prevention of postpartum hemorrhage (PPH) in randomized controlled trials (RCTs).

Methods: Electronic databases (Web of Science, Embase, PubMed, Elsevier ScienceDirect, the Cochrane Library, and ClinicalTrials.gov) were searched from the beginning of indexing to Sep 2021. RCTs comparing oxytocin with non-oxytocin uterotonic agent(s) or non-pharmacologic interventions for the prevention of PPH were eligible.

Results: Overall, sixty-one RCTs meeting the inclusion criteria were included, involving 68834 participants. Twenty-seven types of side-effects were reported in this study. There were 24, 35, or 2 trials assessed as high medium and low quality, respectively. Compared with non-oxytocin, oxytocin had significantly lower risk for shivering (RR=0.31, 95% CI=0.23-0.41, n=36680), fever (RR=0.27, 95% CI=0.20-0.37, n=34031), and diarrhea (RR=0.48, 95% CI=0.35-0.66, n=30883). Other side-effects were not found associated with oxytocin.

Conclusion: Oxytocin use was association with a significantly lower incidence of shivering, fever, and diarrhea events and did not increase risk of other side-effects during the third stage of labor. These observations may aid obstetricians and gynecologists in weighing up the benefits and risks associated with oxytocin in prevention and treatment of PPH during the third stage of labor.

Keywords: Oxytocin; meta-analysis; postpartum hemorrhage; randomized controlled trials; side-effects; systematic review.

Publication types

Review