Outcome in obstetric care related to oxytocin use. A population-based study.
BACKGROUND
The purpose of this study was to investigate the delivery outcome in relation to oxytocin use in labor.


METHODS
We studied 106,755 deliveries from 1995 to 2002 in the Perinatal Revision South, a population-based register comprising information from 10 hospitals in southern Sweden.


RESULTS
Oxytocin use in labor increased from 27.6% in 1995/96 to 33.2% in 2001/02 (p<0.000006). Oxytocin was administered to 47.7% of the nulliparas and 18.5% of the multiparas. There were large differences between hospitals (range among nulliparas: 32.6-60.4%; among multiparas: 13.9-27.0%). After exclusion of deliveries with induction of labor and deliveries lasting >12 h, there was a significant association between oxytocin use and Apgar score < 7 at 5 min (OR 2.3; 95% CI 1.8-2.9), need for neonatal intensive care (OR 1.6; 95% CI 1.5-1.7), and operative delivery (OR 4.0; 95% CI 3.7-4.2).


CONCLUSIONS
In deliveries with relatively short duration (< or =12 h), a significant association was seen between oxytocin use and adverse outcome. Even though the results are difficult to interpret, the significant difference between the use of oxytocin in different hospitals, as well as the increase of oxytocin use over time, calls for a randomized controlled study to elucidate the advantages and disadvantages of oxytocin use during labor and delivery.
Oscarsson
Maria E
ME
Centre for Reproductive Epidemiology (Tornblad's Institute), Lund University, Lund, Sweden. maria.oscarsson@bredband.net
Amer-Wåhlin
Isis
I
Rydhstroem
Hakan
H
Källén
Karin
K
D000138:Acidosis / Q000453:epidemiology; D000328:Adult; D001034:Apgar Score; D002585:Cesarean Section / Q000706:statistics & numerical data; D016001:Confidence Intervals; D036861:Delivery, Obstetric / Q000706:statistics & numerical data; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D015931:Intensive Care, Neonatal / Q000706:statistics & numerical data; D007751:Labor, Induced / Q000379:methods* / Q000706:statistics & numerical data; D007743:Labor, Obstetric / Q000187:drug effects*; D008423:Maternal Age; D016017:Odds Ratio; D010120:Oxytocics / Q000009:adverse effects / Q000627:therapeutic use*; D010121:Oxytocin / Q000009:adverse effects / Q000627:therapeutic use*; D010298:Parity; D011247:Pregnancy; D011256:Pregnancy Outcome; D013548:Sweden; D013997:Time Factors
D010120:Oxytocics; D010121:Oxytocin