Timing of Labor Induction Significantly Impacts Duration, Study Finds
New research from Michigan state University โขreveals a strong link between the time of โday laborโข is induced and its duration, potentially offering a pathwayโข to improved maternal and infant outcomes. The study,published in Molecular Metabolism,combined laboratoryโข investigations using โคmice and human cells with a retrospective analysis of over 2,300 โขpregnancies.
Researchers discovered that labors induced in the early โฃmorning,between 8 a.m. and โnoon, were significantly shorter than those โคinitiated around midnight. This difference was particularly pronounced in patients with gestationalโฃ diabetes, with induction timing impacting labor length by as much as seven hours.
The findings center on BMAL1, a crucial gene regulatingโข theโข body’s circadian rhythm โ- the internal 24-hour clock. Experiments with mice demonstrated โฃthat BMAL1 plays a key role in โcontrolling the oxytocin receptor in the โฃuterus, the โขsame receptor targeted by synthetic oxytocin to stimulate contractions. Suppressing or disabling the BMAL1 gene, either โขgenetically or through a gestational diabetes model, significantly โreduced theโค effectiveness of โoxytocin in inducing contractions.
“We were able to show that BMAL1โ directly controls the oxytocin receptor, which helps explain why timeโข of day changes the drug’sโ effectiveness,” explainedโฃ Hanne Hoffmann, associate professor of animal science at Michigan State University and lead author of the study. “This is the first study โฃto โmake that molecular โฃconnection in the uterus.”
Human cell experiments corroborated these findings, demonstrating a circadian rhythm in the uterus’s response to oxytocin, โconfirming previous hypotheses.
Analysis of labor โขandโ delivery records from Sparrow Health System in Lansing, Michigan, supported the laboratory results.The records, encompassing over 2,300 patients at least 39 weeks pregnant, showed the shortestโฃ labors consistently occurred with inductions between 8 a.m. and noon, while the longestโฃ occurred between midnight and 4 a.m. The effect was most noticeable in โขwomen with gestational diabetes,indicating reduced oxytocin sensitivity during nighttime hours.
Hoffmann emphasized that the research isn’t about convenience, but about optimizing patient care.โ “If we can better align medical โinterventions with a patient’s internal clock, โคwe may improve safety for โคboth mother and baby, while potentially being able to reduce the amount of a drug a woman receives.”
the research team is currently expanding their study โto โฃa larger cohort toโ refine optimal induction timing. Ongoing work โขsuggests that factors like prior births and a woman’s Body Mass Index (BMI) may also โinfluence oxytocin effectiveness. Future research will involve a โprospective study in collaboration with labor โandโข delivery units toโข develop practical guidelines for obstetricians. The ultimate goal is to personalize labor induction, potentially leading to improved delivery outcomes, reduced rates of cesarean sections and NICU admissions, and enhanced recovery โฃfor both mothersโค and newborns.
Source: Michigan State University.
