Huahua Liu,1,* Zhanhong Fan,2,* Fan Wu,2,3,* Mingbo Wang,2 Ziyi Yang,2 Feng Zhang2 

1Affiliated Maternity and Child Health Care Hospital, Nantong University, Nantong, Jiangsu, People’s Republic of China; 2School of Nursing and Rehabilitation, Nantong University, Nantong, Jiangsu, People’s Republic of China; 3Jiangsu Vocational College of Medicine, Yancheng, Jiangsu, People’s Republic of China

*These authors contributed equally to this work

Correspondence: Feng Zhang, School of Nursing and Rehabilitation, Nantong University, Nantong, Jiangsu, People’s Republic of China, Tel +86 13814715979, Email zhangfeng820909@163.com

Background: Previous studies did not investigate the effect of gradually increasing the concentration of low-dose oxytocin on mother and newborn outcomes. The purpose of this study was to look at the relationship between oxytocin responsiveness and outcomes for both mothers and newborns during labor induction.
Methods: This retrospective cohort study was conducted at Nantong Maternal and Child Health Hospital, and participants were divided into the early reaction to oxytocin group and the later reaction to oxytocin group based on oxytocin response. Primary outcomes included Apgar score at 1 and 5 minutes, umbilical cord artery pH, neonatal intensive care unit admission, and postpartum hemorrhage. Secondary outcomes assessed the duration of labor. Multiple regression models were used to compare maternal and infant outcomes between the two groups.
Results: A total of 1803 participants were finally included in the statistical analysis, with 1083 in the early reaction to oxytocin group and 720 in the later reaction to oxytocin group. After adjusting for potential confounding factors, the risk of a lower 1-minute Apgar score (OR: 1.924, 95% CI: 1.012– 3.655), an increased rate of neonatal intensive care unit admission (OR: 2.064, 95% CI: 1.150– 3.703), and a higher incidence of postpartum hemorrhage were observed in the later reaction to oxytocin group (OR: 2.342, 95% CI: 1.631– 3.361). Additionally, in this group, the first and second phases of labor were seen to be more drawn out (P< 0.001, P< 0.001).
Conclusion: Later reaction to oxytocin was consistently associated with lower 1-minute Apgar scores, an increased number of admissions to neonatal intensive care units, a labor’s first and second phases lasting a long time, and an increased occurrence of postpartum hemorrhage. These findings underscore the importance of identifying women who exhibit a delayed response to oxytocin in clinical practice.
Trial Registration: The project was retrospectively registered with the Chinese Clinical Trial Registry (TRN: ChiCTR2100047137; 08/06/2021).

Keywords: oxytocin, labor induction, maternal, neonatal, vaginal delivery