Oxytocin administration prior to planned C-section aims to reduce neonatal respiratory morbidity and improve bonding

Infants born via primary caesarean section without prior labor exhibit significantly lower stress hormone concentrations, such as AVP/copeptin, compared to those born vaginally or after a trial of labor. This lack of a natural stress hormone surge is hypothesized to contribute to increased neonatal respiratory morbidity and potentially impact early maternal-infant bonding and breastfeeding initiation. Current C-section protocols often bypass the physiological processes that prepare an infant for extrauterine life, creating a gap in care that this study aims to address.

This open-label, randomized, placebo-controlled trial will administer an oxytocin challenge test (OCT) prior to planned caesarean delivery. Participants receive an infusion of oxytocin 5 IU/500 ml Ringer® lactate at an initial rate of 12 ml/h, doubled every 10 min until three uterine contractions per 10-min interval are induced, then stopped. The primary endpoint is the incidence of neonatal respiratory morbidity. Secondary endpoints include umbilical cord blood copeptin levels, postnatal neonatal weight change, and breastfeeding status, comparing the intervention group to a placebo control.

This abstract describes the study protocol and objectives; no results are presented yet. The primary objective is to assess if oxytocin administration can reduce the incidence of neonatal respiratory morbidity and admission to the Neonatal Intensive Care Unit. Secondary objectives include evaluating changes in umbilical cord blood copeptin levels, postnatal neonatal weight change over 6 months, and breastfeeding status. The study hypothesizes that triggering uterine contractions will normalize stress hormone responses in newborns, potentially improving their adaptation to extrauterine life and fostering early maternal-infant interactions.

The central hypothesis is that pre-C-section oxytocin will reduce neonatal respiratory morbidity and NICU admissions, while also increasing bonding and breastfeeding rates.