Edwards Hannah, Buisman-Pijlman Femke Ta, Esterman Adrian, Phillips Craig, Orgeig Sandra, Gordon Andrea
UniSA Clinical and Health Sciences, University of South Australia, South Australia, Australia.
UniSA Online, University of South Australia, South Australia, Australia.
Compr Psychoneuroendocrinol. 2024 Aug 28;20:100262. doi: 10.1016/j.cpnec.2024.100262. eCollection 2024 Nov.
Oxytocin is a key hormone in the transition to motherhood. The maternal endogenous oxytocin system facilitates many physiological and biological adaptations, including breastfeeding, maternal wellbeing, and brain plasticity. Additionally, maternal endogenous oxytocin works as a finetuned orchestrator prior to, during, and after the birth of a child to support birth progression and mother-infant bonding. Exogenous oxytocin may be administered to induce or augment labour when this is not progressing naturally and is a common obstetric intervention worldwide. However, the lasting impact of these widely varying levels of systemic exogenous oxytocin on mother-infant bonding is currently unknown. This study aimed to investigate the association between exogenous oxytocin administered to induce or augment labour and quality of observed mother-infant bonding. Thirty-eight mother and infant dyads participated (mothers aged 24-48 years; infants aged 2-5 months). Mother-infant bonding quality was assessed via the Recorded Interaction Task and hospital birth records were consulted to obtain exogenous oxytocin administration data. Demographic information and possible confounding factors were collected from dyads, and salivary oxytocin concentration was measured for both mother and infant. Mother's perception of infant sleep difficulty was identified as a confounding factor for quality of mother-infant bonding. After controlling for the confounding factor, receiving exogenous oxytocin to induce or augment labour, as opposed to not, was found to be significantly positively associated with higher quality of observed mother-infant bonding (p = 0.029). These novel findings highlight the need for further exploration, both of the impact of the treatment and of the mechanisms of action of intrapartum exogenous oxytocin on the endogenous oxytocin system. It is argued that particular focus be given to investigate action on the central oxytocin receptors, and if this may play a role in subsequent mother-infant bonding outcomes. It is vital to understand the full breadth and the clinical implications of this commonplace procedure.
催产素是向母亲角色转变过程中的关键激素。母体的内源性催产素系统促进许多生理和生物学适应过程,包括母乳喂养、母体健康和大脑可塑性。此外,母体的内源性催产素在孩子出生前、出生期间和出生后起着微调协调器的作用,以支持分娩进程和母婴联结。当自然分娩进展不顺利时,可使用外源性催产素诱导或加强宫缩,这是全球常见的产科干预措施。然而,目前尚不清楚这些差异很大的全身性外源性催产素水平对母婴联结的长期影响。本研究旨在调查用于诱导或加强宫缩的外源性催产素与观察到的母婴联结质量之间的关联。38对母婴参与了研究(母亲年龄在24至48岁之间;婴儿年龄在2至5个月之间)。通过记录互动任务评估母婴联结质量,并查阅医院出生记录以获取外源性催产素给药数据。从母婴对中收集人口统计学信息和可能的混杂因素,并测量母亲和婴儿的唾液催产素浓度。母亲对婴儿睡眠困难的感知被确定为母婴联结质量的一个混杂因素。在控制了混杂因素后,发现接受外源性催产素诱导或加强宫缩与未接受的相比,观察到的母婴联结质量更高,且具有显著的正相关(p = 0.029)。这些新发现凸显了进一步探索的必要性,既要探索这种治疗的影响,也要探索产时外源性催产素对内源性催产素系统的作用机制。有人认为应特别关注对中枢催产素受体的作用,以及这是否可能在随后的母婴联结结果中发挥作用。了解这一常见程序的全貌及其临床意义至关重要。