Abstract
Objective This study aimed to investigate the relationship between maternal serum lipid parameters
and oxytocin requirements among women with term vaginal deliveries.
Study Design In this secondary analysis of a prospective cohort study, women who presented for
delivery at ≥37 weeks' gestation and received oxytocin during their labor were included.
Maternal serum was collected intrapartum. The cohort was stratified into two groups
based on maximum oxytocin infusion dose during labor. Primary outcomes were maternal
total cholesterol, low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein
cholesterol (HDL-C), and triglyceride levels. Generalized linear regression models
were used to assess the association between lipid parameters and maximum oxytocin
dose requirements while controlling for potential confounders. For secondary analyses,
the cohort was stratified by HDL-C into two groups. Multivariable logistic regression
was used to evaluate the relationship between low maternal HDL-C and additional intrapartum
oxytocin parameters.
Results There were no differences in maternal total cholesterol, LDL-C, or triglyceride values
between high and low maximum oxytocin groups. Median serum HDL-C was significantly
lower among women in the high oxytocin group compared with those in the low oxytocin
group (56 vs. 62 mg/dL, p < 0.01). For every 0.26 mg/dL lower HDL-C, women had 1 mU/min higher maximum oxytocin
infusion dose during labor. Women with low serum HDL-C were also more likely to require
maximum oxytocin doses above the 75th percentile (adjusted odds ratio [aOR]: 1.99,
95% confidence interval [CI]: 1.06–3.75) and above the 90th percentile (aOR: 2.47,
95% CI: 1.10–5.54). Among women undergoing induction of labor, low serum HDL-C was
also associated with longer duration of oxytocin infusion (aOR: 2.07, 95% CI: 1.02–4.20).
Conclusion Low maternal HDL-C levels at term are associated with higher maximum oxytocin infusion
doses among women undergoing labor induction or augmentation. Given the growing prevalence
of metabolic syndrome in the United States and persistently high rates of cesarean
delivery, HDL-C or its components may present a new target for predicting and improving
labor outcomes.
Key Points
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Serum HDL-C at term is inversely correlated with oxytocin infusion doses at term.
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Low maternal serum HDL-C is associated with higher oxytocin requirements during labor
induction or augmentation.
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No association between maternal serum total cholesterol, LDL-C, or triglyceride levels
and oxytocin requirements in labor.
Keywords
labor - lipids - oxytocin - lipoprotein - uterine contractility
