Thursday, January 21

Does oxygen offer benefits during labor?


The comprehensive analysis published in the journal 'JAMA Pediatrics' looks at 16 previous trials.

The comprehensive analysis published in the journal ‘JAMA Pediatrics’ looks at 16 previous trials.
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A comprehensive analysis, led by researchers at the University of WashingTon School of Medicine in the United States, has found no benefit in providing supplemental oxygen To pregnant women during labor and delivery. To babies born To women who received supplemental oxygen they did not do better or worse than those born To women who had similar birth experiences but without receiving oxygen.

Babies who suffer from oxygen deficiencies during delivery are at risk for brain damage that can lead To developmental delays, cerebral palsy, and even death. To prevent this, most women in labor undergo continuous moniToring of the baby’s heart rate and may receive supplemental oxygen if the heart rate is abnormal, with the idea that this common practice increases the oxygen supply. To the baby.

Now, this comprehensive analysis published in the journal ‘JAMA Pediatrics’, which looks at 16 previous trials of the practice, found no benefit in supplying supplemental oxygen To mothers during labor and delivery.

Each year, 1.5 million women in the United States (two out of three pregnant women) receive supplemental oxygen at some point during labor, according To the researchers. The American College of Obstetricians and Gynecologists recommends decades of practice To treat abnormal fetal heart rate, which may indicate that the baby’s oxygen levels are low and pose health risks.

“It’s such a common practice because the idea is that by giving oxygen To the mother, we are increasing the transfer of oxygen To the baby,” explains the study’s first author, Dr. Nandini Raghuraman, an associate professor of obstetrics and gynecology in the Division of Maternal Fetal Medicine – However, the results of this study suggest that oxygen is not helpful in these cases and that the practice could be safely eliminated for many women. ”

Raghuraman adds that supplemental oxygen is given primarily as a preventative measure, a practice that began during the 1960s. “Fetal moniToring can indicate a possible abnormal problem, such as a lack of oxygen,” he explains. “But about 80% Of the time, women who give birth are in an intermediate category, where the cases are not completely benign, but also not high risk. And in cases like these, oxygen supplementation offers no additional benefits “.

For the analysis, the researchers examined 16 studies published from 1982 To 2020 of randomized controlled trials in humans, including one by researchers from the School of Medicine, which involved More than 2,052 women who gave birth.

“In general, the studies produced mixed results, some indicated a benefit and some indicated no benefit,” Raghuraman said. “That was the reason for doing a meta-analysis. By combining the number of patients in the studies, we could get an answer. More definitive than looking at individual studies. ”

The researchers evaluated the pH levels of the babies’ blood from samples taken shortly after birth. PH measures the acidity and alkalinity of the body in blood and other fluids, with a neutral pH value equal To 7. For babies, Raghuraman notes that anything less than 7.1 is considered abnormal and indicates a lack of oxygen.

The researchers also compared neonatal intensive care admission rates and scores on the Agar test, a well-established test for assessing newborn health at one minute and five minutes after birth. Agar scores measure a baby’s heart rate, breathing, and other signs To determine if the baby needs additional medical attention.

“When comparing the health of babies whose mothers received oxygen and those whose mothers did not, we found that the differences were essentially zero “, SEURA Raghuraman.

Forgoing oxygen supplementation would help reduce unnecessary intervention and likely reduce health care costs.

At Barnes-Jewish Hospital, where Raghuraman helps deliver babies, the findings have started To influence clinical care. “We are being More cautious when administering supplemental oxygen To women during labor,” he acknowledges.

Previous studies have indicated that oxygen supplementation may be beneficial for women giving birth by cesarean section; however, Raghuraman notes that More research is needed.

“We also want To see if exposing the mother and baby To prolonged oxygen during labor can be harmful,” she warns. “Outside of labor and delivery, much research shows that over-oxygenation is associated with oxidative stress. It can cause the type of cell damage that has been implicated in conditions like cerebral palsy and Alzheimer’s disease. Our findings contradict the general myth that increasing oxygen intake is healthy and helpful for a person’s overall well-being. ”

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