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DOI: 10.1055/s-0039-1692196
Oxytocin and Oxytocinase in the Obese and Nonobese Parturients during Induction and Augmentation of Labor
Publication History
27 January 2019
12 April 2019
Publication Date:
29 May 2019 (online)

Abstract
Objective To investigate differences in oxytocin (OXT) biodistribution between nonobese and obese parturients during labor.
Study Design Patients with body mass index (BMI) of either ≥ 18 ≤ 24.9 kg/m2 (“nonobese”) or ≥ 30 kg/m2 (“obese”) undergoing elective induction of labor were included (N = 25 each). Blood samples were collected at baseline (T0), and 20 minutes after maximal OXT augmentation or adequate uterine contractions (T1) for OXT and oxytocinase assays. A mixed-model repeated-measures analysis of variance was used to test for group versus time interaction and analysis of covariance to detect a difference in OXT level at T1. Data presented as mean ± standard deviation or median (interquartile range), with p < 0.05 considered significant.
Results The mean BMIs (kg/m2) were 22.1 ± 1.6 and 35.9 ± 5.1 in the nonobese and obese groups, respectively. No differences were observed in either the duration of OXT infusion, total dose of OXT, or plasma OXT (pg/mL) either at T0 or T1. However, plasma oxytocinase (ng/mL) was significantly lower at T0 (1.41 [0.67, 3.51] vs. 0.40 [0.29, 1.12]; p = 0.03) in the obese group.
Conclusion We provide preliminary evidence that the disposition of OXT may not be different between obese and nonobese women during labor.
Authors' Contribution
A.D.T.: This author helped design the study, conducted the study, reviewed analysis, wrote, and approved the final article.
J.J.: This author helped conduct the study, reviewed analysis, wrote, and approved the final article.
T.F.M.: This author helped design the study, reviewed analysis, and approved the final article.
J.D.B.: This author performed statistical analysis and approved the final article.
A.P.: This author conceived the study, designed the study, conducted the study, reviewed analysis, wrote, and approved the final article.
Competing Interest
The authors declare no competing interest.
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References
- 1 Mission JF, Marshall NE, Caughey AB. Pregnancy risks associated with obesity. Obstet Gynecol Clin North Am 2015; 42 (02) 335-353
- 2 Galtier-Dereure F, Boegner C, Bringer J. Obesity and pregnancy: complications and cost. Am J Clin Nutr 2000; 71 (5, Suppl): 1242S-1248S
- 3 Fyfe EM, Anderson NH, North RA. , et al; Screening for Pregnancy Endpoints (SCOPE) Consortium. Risk of first-stage and second-stage cesarean delivery by maternal body mass index among nulliparous women in labor at term. Obstet Gynecol 2011; 117 (06) 1315-1322
- 4 Barau G, Robillard PY, Hulsey TC. , et al. Linear association between maternal pre-pregnancy body mass index and risk of caesarean section in term deliveries. BJOG 2006; 113 (10) 1173-1177
- 5 Sherrard A, Platt RW, Vallerand D, Usher RH, Zhang X, Kramer MS. Maternal anthropometric risk factors for caesarean delivery before or after onset of labour. BJOG 2007; 114 (09) 1088-1096
- 6 Leddy MA, Power ML, Schulkin J. The impact of maternal obesity on maternal and fetal health. Rev Obstet Gynecol 2008; 1 (04) 170-178
- 7 Carlson NS, Hernandez TL, Hurt KJ. Parturition dysfunction in obesity: time to target the pathobiology. Reprod Biol Endocrinol 2015; 13: 135
- 8 Norman SM, Tuuli MG, Odibo AO, Caughey AB, Roehl KA, Cahill AG. The effects of obesity on the first stage of labor. Obstet Gynecol 2012; 120 (01) 130-135
- 9 Kominiarek MA, Zhang J, Vanveldhuisen P, Troendle J, Beaver J, Hibbard JU. Contemporary labor patterns: the impact of maternal body mass index. Am J Obstet Gynecol 2011; 205 (03) 244.e1-244.e8
- 10 Carlson NS, Corwin EJ, Lowe NK. Oxytocin augmentation in spontaneously laboring, nulliparous women: multilevel assessment of maternal BMI and oxytocin dose. Biol Res Nurs 2017; 19 (04) 382-392
- 11 Cheymol G. Clinical pharmacokinetics of drugs in obesity. An update. Clin Pharmacokinet 1993; 25 (02) 103-114
- 12 Hanley MJ, Abernethy DR, Greenblatt DJ. Effect of obesity on the pharmacokinetics of drugs in humans. Clin Pharmacokinet 2010; 49 (02) 71-87
- 13 Gajdosechova L, Krskova K, Segarra AB. , et al. Hypooxytocinaemia in obese Zucker rats relates to oxytocin degradation in liver and adipose tissue. J Endocrinol 2014; 220 (03) 333-343
- 14 von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP. ; STROBE Initiative. STrengthening the Reporting of OBservational studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. BMJ 2007; 335 (7624): 806-808
- 15 Rahm VA, Hallgren A, Högberg H, Hurtig I, Odlind V. Plasma oxytocin levels in women during labor with or without epidural analgesia: a prospective study. Acta Obstet Gynecol Scand 2002; 81 (11) 1033-1039
- 16 Prevost M, Zelkowitz P, Tulandi T. , et al. Oxytocin in pregnancy and the postpartum: relations to labor and its management. Front Public Health 2014; 2: 1
- 17 Leake RD, Weitzman RE, Fisher DA. Pharmacokinetics of oxytocin in the human subject. Obstet Gynecol 1980; 56 (06) 701-704
- 18 Leake RD, Weitzman RE, Glatz TH, Fisher DA. Plasma oxytocin concentrations in men, nonpregnant women, and pregnant women before and during spontaneous labor. J Clin Endocrinol Metab 1981; 53 (04) 730-733
- 19 Szeto A, McCabe PM, Nation DA. , et al. Evaluation of enzyme immunoassay and radioimmunoassay methods for the measurement of plasma oxytocin. Psychosom Med 2011; 73 (05) 393-400
- 20 Caruso S, Mauro D, Scalia G, Palermo CI, Rapisarda AMC, Cianci A. Oxytocin plasma levels in orgasmic and anorgasmic women. Gynecol Endocrinol 2018; 34 (01) 69-72
- 21 Simpson EA, Paukner A, Sclafani V, Kaburu SS, Suomi SJ, Ferrari PF. Acute oxytocin improves memory and gaze following in male but not female nursery-reared infant macaques. Psychopharmacology (Berl) 2017; 234 (03) 497-506
- 22 Mathur VS, Walker JM. Oxytocinase in plasma and placenta in normal and prolonged labour. BMJ 1968; 3 (5610): 96-97
- 23 Yamahara N, Nomura S, Suzuki T. , et al. Placental leucine aminopeptidase/oxytocinase in maternal serum and placenta during normal pregnancy. Life Sci 2000; 66 (15) 1401-1410
- 24 Ito N, Nomura S, Iwase A. , et al. Ultrastructural localization of aminopeptidase A/angiotensinase and placental leucine aminopeptidase/oxytocinase in chorionic villi of human placenta. Early Hum Dev 2003; 71 (01) 29-37
- 25 Naruki M, Mizutani S, Goto K. , et al. Oxytocin is hydrolyzed by an enzyme in human placenta that is identical to the oxytocinase of pregnancy serum. Peptides 1996; 17 (02) 257-261
- 26 Oya M, Yoshino M, Mizutani S, Wakabayashi T. The origin of human pregnancy serum oxytocinase. Gynecol Invest 1974; 5 (5-6): 276-283
- 27 Ferrier BM, Hendrie JM, Branda LA. Plasma oxytocinase: the synthesis and biological properties of the first product of the degradation of oxytocin by this enzyme. Can J Biochem 1974; 52 (01) 60-66
- 28 Howell KR, Powell TL. Effects of maternal obesity on placental function and fetal development. Reproduction 2017; 153 (03) R97-R108
- 29 Tsujimoto M, Mizutani S, Adachi H, Kimura M, Nakazato H, Tomoda Y. Identification of human placental leucine aminopeptidase as oxytocinase. Arch Biochem Biophys 1992; 292 (02) 388-392
- 30 Mizutani S, Sumi S, Oka K. , et al. In vitro degradation of oxytocin by pregnancy serum, placental subcellular fractions and purified placental aminopeptidases. Exp Clin Endocrinol 1985; 86 (03) 310-316