Impact of opioid use disorder on oxytocin required for labor induction in term pregnancies.

OBJECTIVE

Oxytocin is a neuropeptide proven to impact human labor, lactation, and social affinity and is of interest in the study of pain and μ-opioid receptor modulation. Individuals impacted by opioid use disorder (OUD) frequently have μ-opioid receptor dysregulation. In this study, we sought to investigate the effect of OUD on the effectiveness of synthetic oxytocin in term inductions of labor.

STUDY

DESIGN

Matched retrospective cohort study of individuals with term pregnancies undergoing induction of labor with oxytocin from 2020 to 2024 at an urban safety-net hospital. The total amount of oxytocin required to achieve vaginal delivery and total induction of labor time were compared between those with OUD and those without. The groups were matched by age, parity, gestational age, month of delivery, and body mass index. Wilcoxon signed-rank tests were used to compare continuous variables between two groups.

RESULTS

This study evaluated 212 (106 without OUD and 106 with OUD) individual vaginal deliveries. There was no significant difference in total oxytocin dose used for induction between patients with OUD and those without OUD. While total induction time was longer in patients with OUD (median 710 vs. 590 min, p = 0.018), this difference was no longer significant after adjusting for Foley balloon use and age (p = 0.105). However, patients with OUD spent an estimated 66 min longer in induction after amniotomy than those without OUD (median 269 vs. 335 min, p = 0.015).

CONCLUSION

Individuals with OUD were not found to have significantly different total required oxytocin doses to deliver than those without OUD. However, patients with OUD experienced significantly longer induction time following amniotomy compared to those without OUD. Further studies are needed to examine the impact of OUD on induction of labor with oxytocin.