Subramaniam Akila, Owen John, Campbell Sukhkamal B, Harper Lorie M, Fitzwater Joseph L, Edwards Rodney K
a Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology , University of Alabama at Birmingham , Birmingham , AL , USA.
b Department of Obstetrics and Gynecology , University of Alabama at Birmingham , Birmingham , AL , USA.
J Matern Fetal Neonatal Med. 2018 Aug;31(15):2013-2018. doi: 10.1080/14767058.2017.1334046. Epub 2017 Jun 6.
Increasing body mass index (BMI) and administered doses of oxytocin are related to maternal and neonatal morbidities. We evaluated the effect of oxytocin dosage, BMI, and their interaction on select perinatal outcomes.
We retrospectively studied nulliparas with singletons ≥36 weeks' gestation who received oxytocin and reached the second stage of labor. Oxytocin dosage was defined by the oxytocin product ([maximum oxytocin dose] × [duration of oxytocin infusion]/100 (milliunits)). Outcomes included cesarean, postpartum hemorrhage, puerperal infection, and a composite of neonatal morbidities. Logistic regression produced odds ratios (OR) for BMI and oxytocin product. The final model included a BMI-oxytocin product interaction term.
One thousand two hundred and four women met enrollment criteria. Increasing BMI was associated with longer duration from first exam to delivery and higher rates of cesarean. Oxytocin dosage increased linearly with BMI (p < .001). There were increasing odds of all four outcomes as both BMI and oxytocin dosage increased (except cesarean with oxytocin). However, there was no significant interaction between BMI and oxytocin for any outcome.
BMI and oxytocin dosage are associated with select maternal and neonatal outcomes. However, the lack of interaction between BMI and oxytocin product suggests that the higher administered dose of oxytocin associated with increasing BMI does not synergistically potentiate maternal and neonatal morbidities.
体重指数（BMI）增加以及催产素给药剂量与孕产妇和新生儿发病率相关。我们评估了催产素剂量、BMI及其相互作用对特定围产期结局的影响。
我们回顾性研究了孕周≥36周、接受催产素并进入第二产程的单胎初产妇。催产素剂量由催产素产品定义（[最大催产素剂量]×[催产素输注持续时间]/100（毫单位））。结局包括剖宫产、产后出血、产褥感染以及新生儿发病率的综合情况。逻辑回归得出BMI和催产素产品的比值比（OR）。最终模型纳入了BMI - 催产素产品交互项。
1204名女性符合纳入标准。BMI增加与首次检查至分娩的持续时间延长以及剖宫产率升高相关。催产素剂量随BMI呈线性增加（p < 0.001）。随着BMI和催产素剂量均增加，所有四种结局的发生几率均增加（催产素相关的剖宫产除外）。然而，BMI与催产素之间对于任何结局均无显著交互作用。
BMI和催产素剂量与特定的孕产妇和新生儿结局相关。然而，BMI与催产素产品之间缺乏交互作用表明，与BMI增加相关的更高催产素给药剂量并不会协同增强孕产妇和新生儿的发病率。
