Childhood Maltreatment, Labor Duration, and Intrapartum Synthetic Oxytocin Dose and Duration: A Potential Oxytocin-Linked Contributor to Labor Outcomes in Black Birthing People

IF 2.3 4区 医学 Q2 NURSING
Abby Britt CNM, MSN, MA Public Anthropology, Melinda Higgins PhD, Anne Dunlop MD, MPH, Vasiliki Michopoulos PhD, Nicole Carlson CNM, PhD
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引用次数: 0

Abstract

Introduction

Black pregnant people are disproportionately impacted by childhood maltreatment and maternal morbidity and mortality related to labor dysfunction. One largely unexplored link between these disparities is the maternal oxytocin system, which is affected by childhood maltreatment and integral to labor. The current study examines relationships between maternal childhood maltreatment, labor duration, and intrapartum synthetic oxytocin requirements.

Methods

This is a secondary data analysis of a completed prospective cohort study involving Black pregnant people recruited from 2 academic medical centers in Atlanta, Georgia. Participants had no health complications, term labor, and a singleton fetus in cephalic presentation (N = 109). Childhood maltreatment was assessed using the Childhood Trauma Questionnaire. Labor duration and synthetic oxytocin data were collected via health record abstraction. Associations were examined between childhood maltreatment, labor duration, and synthetic oxytocin requirements after stratification by mode of labor onset.

Results

No significant associations were found between childhood maltreatment and labor duration in the total sample (N = 109). However, among the induction of labor sample (n = 47), both small-to-moderate and larger associations were found between childhood emotional (β, 0.253; P = .073) and physical (β, 0.398; P = .003) abuse and labor duration after adjusting for parity, epidural analgesia use, and body mass index. Additionally, in the labor induction sample, there were significant, moderate-to-large associations between higher levels of childhood physical abuse with higher intrapartum synthetic oxytocin dose (ρ, 0.433; P = .002), longer duration (ρ, 0.381; P = .008), and higher average dose per hour (ρ, 0.312; P = .033).

Discussion

In a sample of Black pregnant people who underwent labor induction, childhood emotional and physical abuse were associated with longer labor duration. Childhood physical abuse was associated with higher synthetic oxytocin requirements. Further research is needed to understand the potential relationships between maternal childhood maltreatment and labor outcomes to inform future interventions toward birth outcome equity.

儿童期虐待、分娩持续时间和产时合成催产素剂量和持续时间:一种潜在的与催产素相关的黑人分娩结果的影响因素。
背景:黑人孕妇受到儿童虐待和与分娩功能障碍相关的产妇发病率和死亡率的影响不成比例。这些差异之间的一个很大程度上未被探索的联系是母亲的催产素系统,它受到童年虐待的影响,是分娩不可或缺的一部分。目前的研究探讨了母亲童年虐待、分娩持续时间和分娩时合成催产素需求之间的关系。方法:这是一项已完成的前瞻性队列研究的辅助数据分析,该研究涉及从佐治亚州亚特兰大的2个学术医疗中心招募的黑人孕妇。参与者无健康并发症、足月分娩和头位单胎(N = 109)。使用儿童创伤问卷对儿童虐待进行评估。通过健康记录提取收集分娩持续时间和合成催产素数据。根据分娩方式分层后,研究了儿童虐待、分娩持续时间和合成催产素需求之间的关系。结果:在总样本中,儿童虐待与分娩时间无显著关联(N = 109)。然而,在引产样本(n = 47)中,儿童情绪与分娩之间存在小到中等和较大的关联(β, 0.253;P = 0.073)和物理(β, 0.398;在调整胎次、硬膜外镇痛使用和体重指数后,P = 0.003)滥用和分娩持续时间。此外,在引产样本中,较高的儿童身体虐待水平与较高的分娩时合成催产素剂量之间存在显著的中等到较大的关联(ρ, 0.433;P = 0.002),持续时间较长(ρ, 0.381;P = 0.008),且每小时平均剂量较高(ρ, 0.312;P = .033)。讨论:在一个接受引产的黑人孕妇样本中,儿童时期的情感和身体虐待与更长的分娩时间有关。儿童时期的身体虐待与更高的合成催产素需求有关。需要进一步的研究来了解母亲童年虐待和分娩结果之间的潜在关系,以便为未来的分娩结果公平干预提供信息。
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来源期刊
CiteScore
3.60
自引率
7.40%
发文量
103
审稿时长
6-12 weeks
期刊介绍: The Journal of Midwifery & Women''s Health (JMWH) is a bimonthly, peer-reviewed journal dedicated to the publication of original research and review articles that focus on midwifery and women''s health. JMWH provides a forum for interdisciplinary exchange across a broad range of women''s health issues. Manuscripts that address midwifery, women''s health, education, evidence-based practice, public health, policy, and research are welcomed
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