Oxytocin and catechol-O-methyltransferase receptor genotype predict the length of the first stage of labor
ABSTRACT We aimed to identify genetic factors that influence the rate of the first stage of labor.
We prospectively enrolled 233 laboring nulliparous parturients. Demographic, clinical, and genetic data were collected. We evaluated the influence of population and individual variability using a nonlinear mixed effects model.
Parturients who were homozygous for "G" at oxytocin receptor gene rs53576 transitioned to active labor later and thus had slower labor. Catechol-O-methyltransferase rs4633 genotype TT was associated with slower latent phase labor. Labor induction with prostaglandin was associated with faster labor, and request for meperidine was associated with slower labor. Birthweight was related inversely to the rate of the active phase.
There are demographic, clinical, and genetic factors that influence an individual's rate of labor progress. This information could be used in automated form to improve the prediction of the length of the first stage of labor.
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ABSTRACT: ABsTRACT The aim of this review is to describe pharmacological and non-pharmacological factors that have an effect on duration of the labor. Approximately all published articles from 1980–2013 in Medline and Embase were searched amongst them 118 articles were selected. The eligible studies were those that reported the labor length, labor duration and active labor. Studies including preterm, premature and labor induction were excluded and finally fifty-six articles were reviewed. Oxytocin, propranolol, Pethidine, Epidural analgesia, Nitrous Oxide and Intravenous Hydration are common pharmacological methods affecting the labor duration. Massage, Birth ball, Acupressure, Oral carbohydrate intake, Presence of companionship, Water birth delivery and Parturient position are considered as the main effective non-pharmacological methods on labor duration. Implementation of non-pharmacological methods, as effective factors on labor duration, is recommended.Biomedical and Pharmacology Journal 12/2013; 6(2):161-167. DOI:10.13005/bpj/399
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ABSTRACT: The "What's New in Obstetric Anesthesia?" keynote lecture was established by the Society for Obstetric Anesthesia and Perinatology in memory of the eminent obstetric anesthesiologist, Dr. Gerard W. Ostheimer. From a wide selection of journals encompassing the fields of obstetric anesthesia, obstetrics, and perinatology, the designated lecturer identifies articles of significant impact and interest published in the preceding year. The Ostheimer lecture, delivered this year at the annual meeting of the Society in April 2013 in San Juan, Puerto Rico, included highly relevant papers that have the potential to change obstetric anesthesia practice or impact public health. This review summarizes 5 categories of pertinent articles that were published in 2012 and discussed in the 2013 Ostheimer lecture: maternal diseases, labor and delivery, advances in obstetric anesthesia, obstetric complications, and anesthesia-related complications.Anesthesia and analgesia 02/2014; 118(2):360-6. DOI:10.1213/ANE.0000000000000101 · 3.42 Impact Factor
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ABSTRACT: Variability in labor pain has been associated with demographic, clinical, and psychological factors. Polymorphisms of the β2-adrenergic receptor gene (ADRB2) influence sensitivity to experimental pain in humans and are a risk factor for chronic pain. The authors hypothesized that polymorphisms in ADRB2 may influence labor pain. After Institutional Review Board approval and written informed consent, the authors prospectively obtained hourly pain reports from 233 nulliparous parturients during the first stage of labor, of which 199 were included in the current analysis. DNA from blood samples was genotyped at polymorphisms in the genes for the β2-adrenergic receptor, the μ opioid receptor subtype 1, catechol-O-methyltransferase, fatty acid amide hydrolase, and the oxytocin receptor. Labor pain as a function of cervical dilation was modeled with previously described methods. Patient covariates, ADRB2 genotype, and obstetrical and anesthesia treatment were evaluated as covariates in the model. Labor pain more rapidly became severe in parturients heterozygous or homozygous for the G allele at rs1042714 in the ADRB2 gene. Labor pain increased more rapidly after artificial rupture of membranes, augmentation with oxytocin, and in younger women. Inclusion of covariates explained approximately 10% of the variability between subjects. ADRB2 genotype explained less than 1% of the intersubject variability. ADRB2 genotype correlates with labor pain but explained less than 1% of the intersubject variance in the model.Anesthesiology 07/2014; DOI:10.1097/ALN.0000000000000258 · 6.17 Impact Factor