Fetal exposure to synthetic oxytocin and the relationship with prefeeding cues within one hour postbirth

Background: Prefeeding cues are oral-motor neurobehaviors that communicate feeding readiness, and the ability to self-comfort and regulate behavioral state. Intrapartum and newborn procedures have been associated with altered frequency and emergence of prefeeding cues soon after birth. Intrapartum synthetic oxytocin is commonly used for labor induction/augmentation in the US, yet there is little research on potential effects on infant neurobehavioral cues.

Aims: To explore whether fetal exposure to synthetic oxytocin was associated with the infant's level of prefeeding organization shortly after birth.

Study design: Cohort.

Subjects: A convenience sample of 47 healthy full-term infants (36 exposed and 11 unexposed to intrapartum synthetic oxytocin) was studied.

Exclusion criteria: Fetal distress, vacuum/forceps, cesarean, and low Apgar.

Outcome measures: Videotapes of infants (45-50min postbirth) were coded for frequency of eight prefeeding cues, and analyzed by level of prefeeding organization.

Results: In general, fewer prefeeding cues were observed in infants exposed versus unexposed to synOT and differences were significant for brief and sustained hand to mouth cues [incidence rate ratio (95% CI)=0.6 (0.4, 0.9) and 0.5 (0.2, 0.9), respectively]. Forty-four percent of exposed infants demonstrated a low level of prefeeding organization, compared to 0% from the unexposed group. In contrast, 25% of exposed versus 64% of unexposed infants demonstrated high prefeeding organization. After adjusting for covariates, exposed infants were at 11.5 times (95% CI=1.8-73.3) the odds of demonstrating low/medium versus high levels of prefeeding organization compared to unexposed infants.

Conclusions: Newborn neurobehavioral cues may be sensitive to intrapartum synthetic oxytocin.